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DERMATOLOGIC SURGERY CENTER OF NORTHEAST OHIO INC
NPI 1205104601
Dermatology - MOHS-Micrographic Surgery in Medina, OH

Active since December 13, 2011CLIA 36D2032981 · Certificate of Compliance
1133 MEDINA RD, SUITE 100, MEDINA, OH 44256(330) 238-4350(330) 239-4584 Get Directions Write a Review

NPPES record last updated: February 27, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dermatologic Surgery Center Of Northeast Ohio Inc NPPES

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

DERMATOLOGIC SURGERY CENTER OF NORTHEAST OHIO INC (NPI 1205104601) is a healthcare organization registered as a mohs-micrographic surgery in Medina, Ohio and active in the NPI registry since December 2011. The organization holds a CLIA Certificate of Compliance certificate valid through January 17, 2027 and lists Jennifer Popovsky, President, as its authorized official.

NPPES Registry Identity

NPI1205104601
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameDERMATOLOGIC SURGERY CENTER OF NORTHEAST OHIO INC
Location Address1133 MEDINA RD, SUITE 100Medina, OH 44256-0000
Mailing Address1133 Medina Rd, Suite 100Medina, OH 44256 · (330) 239-4350 · Fax (330) 239-4584
Phone(330) 238-4350
Fax(330) 239-4584
Organization SubpartNo
Authorized OfficialJennifer PopovskyPresident · (330) 239-4350
Enumeration DateDecember 13, 2011
Last NPPES UpdateFebruary 27, 2012
✔ NPI 1205104601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in OH · 35076146P
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
1133 MEDINA RD, Medina, OH 44256
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Other Identifiers 3

Medicaid2190785OH
Medicare PINPO4032241OH
Medicare UPINH24383OH

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 36D2032981

Dermatologic Surgery Center Of Northeast Ohio, The · Medina, OH
Active · expires Jan 17, 2027
CLIA Number36D2032981
Laboratory TypePhysician Office
Certificate Effective DateJanuary 18, 2025
Certificate Expiration DateJanuary 17, 2027
Laboratory DirectorJennifer Popovsky
Laboratory Phone(330) 239-4350
Laboratory LocationDermatologic Surgery Center Of Northeast Ohio, The1133 Medina Road, Suite 100, Medina, OH 44256
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GALAXY MEDICAL PRODUCTS, LLC
Durable Medical Equipment & Medical Supplies
1133 MEDINA RD, STE 800
MEDINA, OH 44256
Medina County (330) 665-4700

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 Dermatologic Surgery Center Of Northeast Ohio Inc's NPI number?

The NPI number for Dermatologic Surgery Center Of Northeast Ohio Inc is 1205104601. It was assigned to this organization in the NPPES registry on December 13, 2011.

Where is Dermatologic Surgery Center Of Northeast Ohio Inc located?

Dermatologic Surgery Center Of Northeast Ohio Inc is located at 1133 Medina Rd Suite 100, Medina, OH 44256. The listed phone number is (330) 238-4350.

What is Dermatologic Surgery Center Of Northeast Ohio Inc's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Dermatologic Surgery Center Of Northeast Ohio Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 36D2032981) is associated with this NPI, valid through January 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermatologic Surgery Center Of Northeast Ohio Inc accept?

Health plans from Anthem Blue Cross and Blue Shield list Dermatologic Surgery Center Of Northeast Ohio Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dermatologic Surgery Center Of Northeast Ohio Inc was last updated on February 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.