UPTOWN DERMATOLOGY & SKIN SPA, P.A.
NPI 1205868619
Dermatology in Minneapolis, MN

Active since July 07, 2006
1221 W LAKE ST, SUITE 208, MINNEAPOLIS, MN 55408(612) 455-3200 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Uptown Dermatology & Skin Spa, P.a. NPPES

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

UPTOWN DERMATOLOGY & SKIN SPA, P.A. (NPI 1205868619) is a healthcare organization registered as a dermatology in Minneapolis, Minnesota and active in the NPI registry since July 2006. The organization lists Jaime Davis, Owner, as its authorized official.

NPPES Registry Identity

NPI1205868619
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameUPTOWN DERMATOLOGY & SKIN SPA, P.A.
Location Address1221 W LAKE ST, SUITE 208Minneapolis, MN 55408-3397
Mailing Address1221 W Lake St, Suite 208Minneapolis, MN 55408-3397 · (612) 455-3200
Organization SubpartNo
Authorized OfficialJaime DavisOwner · (612) 455-3200
Enumeration DateJuly 7, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1205868619 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.
1221 W LAKE ST, Minneapolis, MN 55408

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)

Uptown Dermatology & Skin Spa, P.a. 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 Uptown Dermatology & Skin Spa, P.A., which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1326063439
1221 W LAKE ST SUITE 208
Minneapolis, MN 55408
(612) 455-3200
✔ 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.

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 Uptown Dermatology & Skin Spa, P.A.'s NPI number?

The NPI number for Uptown Dermatology & Skin Spa, P.A. is 1205868619. It was assigned to this organization in the NPPES registry on July 7, 2006.

Where is Uptown Dermatology & Skin Spa, P.A. located?

Uptown Dermatology & Skin Spa, P.A. is located at 1221 W Lake St Suite 208, Minneapolis, MN 55408. The listed phone number is (612) 455-3200.

What is Uptown Dermatology & Skin Spa, P.A.'s specialty?

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

Is Uptown Dermatology & Skin Spa, P.A. enrolled in Medicare?

Yes. Uptown Dermatology & Skin Spa, P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Uptown Dermatology & Skin Spa, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Uptown Dermatology & Skin Spa, P.A.. 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 Uptown Dermatology & Skin Spa, P.A. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.