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SYNERGY DERMATOLOGY
NPI 1174385652
Dermatology in San Francisco, CA

Active since January 29, 2024CLIA 05D2313467 · Certificate of Compliance
595 BUCKINGHAM WAY STE 220, SAN FRANCISCO, CA 94132(415) 333-0348(415) 333-0349 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Synergy Dermatology NPPES

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

SYNERGY DERMATOLOGY (NPI 1174385652) is a healthcare organization registered as a dermatology in San Francisco, California and active in the NPI registry since January 2024. The organization holds a CLIA Certificate of Compliance certificate valid through March 10, 2028 and lists Tina Bhutani-jacques, Owner, as its authorized official.

NPPES Registry Identity

NPI1174385652
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameTINA BHUTANI-JACQUES, MD, INC
Location Address595 BUCKINGHAM WAY STE 220San Francisco, CA 94132-1910
Mailing Address595 Buckingham Way Ste 220San Francisco, CA 94132-1910 · (714) 235-9633 · Fax (415) 333-0349
Phone(415) 333-0348
Fax(415) 333-0349
Organization SubpartNo
Authorized OfficialTina Bhutani-jacquesOwner · (714) 235-9633
Enumeration DateJanuary 29, 2024
Last NPPES UpdateFebruary 12, 2024
NPPES CertifiedFebruary 12, 2024
✔ NPI 1174385652 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.
595 BUCKINGHAM WAY STE 220, San Francisco, CA 94132
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Other Names 1

Doing Business AsSynergy Dermatology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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)

Synergy Dermatology 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 Synergy Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tina Bhutani, MD
Dermatology
NPI 1144483124
595 BUCKINGHAM WAY STE 220
San Francisco, CA 94132
(415) 333-0348
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D2313467

Tina Bhutani Jacques MD Inc · San Francisco, CA
Active · expires Mar 10, 2028
CLIA Number05D2313467
Laboratory TypePhysician Office
Certificate Effective DateMarch 11, 2026
Certificate Expiration DateMarch 10, 2028
Laboratory DirectorTina Bhutani-Jacques
Laboratory Phone(415) 333-0348
Laboratory LocationTina Bhutani Jacques MD Inc595 Buckingham Way, Ste 220, San Francisco, CA 94132
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Tina Bhutani-Jacques, MD, Inc's NPI number?

The NPI number for Tina Bhutani-Jacques, MD, Inc is 1174385652. It was assigned to this organization in the NPPES registry on January 29, 2024. The provider is doing business as Synergy Dermatology.

Where is Tina Bhutani-Jacques, MD, Inc located?

Tina Bhutani-Jacques, MD, Inc is located at 595 Buckingham Way Ste 220, San Francisco, CA 94132. The listed phone number is (415) 333-0348.

What is Tina Bhutani-Jacques, MD, Inc's specialty?

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

Is Tina Bhutani-Jacques, MD, Inc enrolled in Medicare?

Yes. Tina Bhutani-Jacques, MD, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tina Bhutani-Jacques, MD, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Tina Bhutani-Jacques, MD, Inc. 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.

Does Tina Bhutani-Jacques, MD, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D2313467) is associated with this NPI, valid through March 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tina Bhutani-Jacques, MD, Inc was last updated on February 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.