INTEGRATED DERMATOLOGY OF LINCOLN, PC
NPI 1104585884
Dermatology in Red Bluff, CA

Active since December 10, 2021
2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080(530) 527-0414 Get Directions Write a Review

NPPES record last updated: December 10, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Integrated Dermatology Of Lincoln, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTEGRATED DERMATOLOGY OF LINCOLN, PC (NPI 1104585884) is a healthcare organization registered as a dermatology in Red Bluff, California and active in the NPI registry since December 2021. The organization lists Jennifer T Haley, Authorized Group Official, as its authorized official.

NPPES Registry Identity

NPI1104585884
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF LINCOLN, PC
Location Address2450 SISTER MARY COLUMBA DRRed Bluff, CA 96080-4356
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000 · Fax (561) 431-2821
Organization SubpartNo
Authorized OfficialJennifer T HaleyAuthorized Group Official · (561) 314-2000
Enumeration DateDecember 10, 2021
NPPES CertifiedDecember 10, 2021
✔ NPI 1104585884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
2450 SISTER MARY COLUMBA DR, Red Bluff, CA 96080

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Integrated Dermatology Of Lincoln, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Integrated Dermatology Of Lincoln, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1659352219
2295 FIELDSTONE DRIVE SUITE 150
Lincoln, CA 95648
(530) 527-0414
✔ PECOS✔ Accepts Medicare103 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Integrated Dermatology Of Lincoln, PC's NPI number?

The NPI number for Integrated Dermatology Of Lincoln, PC is 1104585884. It was assigned to this organization in the NPPES registry on December 10, 2021.

Where is Integrated Dermatology Of Lincoln, PC located?

Integrated Dermatology Of Lincoln, PC is located at 2450 Sister Mary Columba Dr, Red Bluff, CA 96080. The listed phone number is (530) 527-0414.

What is Integrated Dermatology Of Lincoln, PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Integrated Dermatology Of Lincoln, PC enrolled in Medicare?

Yes. Integrated Dermatology Of Lincoln, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Dermatology Of Lincoln, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Integrated Dermatology Of Lincoln, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Integrated Dermatology Of Lincoln, PC was last updated on December 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.