Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

LAERTES A MANUELIDIS M.D.
NPI 1245220698
Dermatology - Procedural Dermatology in Fort Myers, FL

Q: What is Laertes Manuelidis's NPI number?

The NPI number for Laertes Manuelidis is 1245220698. It was assigned to this individual provider in the NPPES registry on October 26, 2005.

Q: What is Laertes Manuelidis's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Active since October 26, 2005PECOS Enrolled

75/100

CMS Quality Rating

8381 RIVERWALK PARK BLVD, SUITE 1, FORT MYERS, FL 33919(239) 936-5425(239) 936-5176 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

On this page

About Laertes A Manuelidis M.d. NPPES

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

LAERTES A MANUELIDIS M.D. (NPI 1245220698) is an individual procedural dermatology provider in Fort Myers, Florida, licensed in Florida (ME87314) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Yale University School Of Medicine (1997).

NPPES Registry Identity

NPI1245220698

Entity TypeIndividualMale

Primary Taxonomy207NS0135X

Provider Legal NameLAERTES A MANUELIDISCredential: M.D.

Location Address8381 RIVERWALK PARK BLVD, SUITE 1Fort Myers, FL 33919-8760

Mailing Address8381 Riverwalk Park Blvd, Suite 101Fort Myers, FL 33919-8760 · (239) 936-5425 · Fax (239) 936-5176

Phone(239) 936-5425

Fax(239) 936-5176

Sole ProprietorNo

Medical School CMSYale University School Of MedicineGraduated 1997

Enumeration DateOctober 26, 2005

Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration

✔ NPI 1245220698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

License✔ Licensed in FL · ME87314

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Also ListedPathology · DermatopathologyTaxonomy 207ZD0900X · License ME87314 (FL)

8381 RIVERWALK PARK BLVD, Fort Myers, FL 33919

Open in Google Maps ↗

Other Identifiers 3

Other7082420FL · Aetna

Other78611FL · Bc Bs Of Fla

OtherP00038301FL · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Laertes A Manuelidis M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294708541

PECOS Enrollment IDI20040816000997

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 54

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, tildrakizumab, 1 mg J3245

Tildrakizumab is a medication injected under the skin to treat moderate to severe plaque psoriasis, a skin condition. It works by reducing the effects of a substance in the body that can cause inflammation.

12,800 services37 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

7,105 services3,711 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

2,824 services1,623 patients

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

2,476 services541 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

1,267 services913 patients

Special stained specimen slides to examine tissue, each additional procedure 88341

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

724 services537 patients

Special stained specimen slides to examine tissue, initial procedure 88342

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

667 services570 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

365 services331 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm 11301

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

354 services305 patients

Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm 11302

This procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.

300 services262 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

245 services161 patients

Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less 15271

This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.

195 services52 patients

Pathology examination of tissue using a microscope, moderately low complexity 88304

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

168 services159 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

164 services43 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

163 services153 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 11311

This procedure involves removing a small skin growth on the face or related areas like the ears, eyelids, nose, lips, or mouth. The growth is gently shaved off, typically under local anesthesia. It's a quick, safe process for growths between 0.6-1.0 cm in size.

160 services148 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

156 services115 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

143 services127 patients

Special stained specimen slides to identify organisms including interpretation and report 88312

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

136 services114 patients

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 17281

This procedure involves the removal of cancerous skin growths on the face, ears, eyelids, nose, lips, or mouth that are between 0.6-1.0 cm in size. The goal is to eliminate cancer cells, preventing further spread and promoting health.

126 services101 patients

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm 17261

This procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.

116 services93 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

97 services97 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm 11306

This procedure involves the careful removal of a small skin growth, between 0.6-1.0 cm in size, from the scalp, neck, hands, or feet. It's done using a special tool to gently shave off the growth, ensuring minimal discomfort.

89 services81 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

83 services72 patients

Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 17272

This procedure involves the removal of a cancerous skin growth measuring 1.1-2.0 cm, located on the scalp, neck, hands, or feet. The process may involve techniques like surgery, laser, or cryotherapy. The aim is to eliminate the cancer cells and prevent further spread.

68 services58 patients

Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm 17271

This procedure involves the removal of a small cancerous skin growth, between 0.6 to 1.0 cm, located on the scalp, neck, hands, or feet. The aim is to eliminate the cancerous cells and prevent their spread. The treatment is done in a safe, controlled environment.

58 services50 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm 11603

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

57 services53 patients

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 17282

This procedure involves the removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth that measures between 1.1 to 2.0 cm. It's done to prevent the spread of cancer and improve health.

57 services51 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 11312

This procedure involves the careful removal of a skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth being treated is between 1.1 and 2.0 cm in size. The process is typically quick, with minimal discomfort, and aids in maintaining skin health.

56 services55 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 11307

This procedure involves the careful removal of a skin growth between 1.1 to 2.0 cm in size. The growth could be located on the scalp, neck, hands, or feet. The process is done using a sharp instrument to shave off the growth, promoting healthier skin.

50 services49 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

48 services39 patients

Destruction of skin growth, 15 or more growths 17111

"Destruction of skin growth" refers to a procedure where unwanted skin growths, such as warts or moles, are removed. In this case, 15 or more growths are treated. Techniques may include freezing, burning, or laser therapy. It's a safe, quick process to improve skin health.

47 services43 patients

Biopsy of eyelid 67810

A biopsy of the eyelid is a procedure where a small piece of tissue is taken from your eyelid for examination. It helps identify any abnormal growth like a lump or cyst. It's done under local anesthesia, so you won't feel pain during the process.

46 services44 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

46 services25 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

45 services39 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less 11310

This procedure involves the careful removal of a small skin growth on the face or related areas. A medical professional uses a special tool to gently shave off the growth, which is 0.5 cm or less. It's a common, safe procedure.

43 services39 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 11642

This procedure involves the surgical removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth is between 1.1-2.0 cm in size. This is done to prevent the cancer from spreading and to restore health.

38 services34 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

37 services36 patients

Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) J7308

Aminolevulinic Acid HCL is a medication applied to the skin to treat certain types of skin conditions. It works by making the skin more sensitive to light, which helps to kill abnormal skin cells. The 20% solution is a single dose of 354 mg.

34 services21 patients

Injection into skin growth, more than 7 growths 11901

This procedure involves injecting medication into multiple skin growths (more than 7) to either shrink them or eliminate them. It's a safe, minimally invasive method often used for benign growths. Comfort during the process is ensured.

32 services15 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

26 services26 patients

Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm 17263

This procedure targets and eliminates a cancerous skin growth between 2.1 and 3.0 cm on your trunk, arms, or legs. It's done by applying specific treatments like heat, cold, or medicated creams to destroy the cancer cells, preventing them from spreading.

25 services24 patients

Biopsy of lip 40490

A biopsy of the lip involves removing a small piece of tissue from your lip. This tissue is then examined under a microscope to check for abnormalities, like cancer. The procedure is typically quick and involves a local anesthetic to minimize discomfort.

24 services23 patients

Biopsy of ear 69100

A biopsy of the ear is a medical procedure where a small sample of tissue is taken from your ear for examination. This helps doctors diagnose any abnormalities or diseases. It's a simple process, usually done under local anesthesia, and has minimal risks.

23 services18 patients

Application of light to destroy precancer skin growth 96567

This procedure involves the use of special light to eradicate precancerous skin growths. The light targets abnormal cells causing them to die off, while leaving healthy skin unharmed. It's a non-invasive method that helps prevent skin cancer.

22 services21 patients

Shaving of skin growth of body, arms, or legs, more than 2.0 cm 11303

This procedure involves the removal of a skin growth on your body, arms, or legs that is over 2.0 cm. A special tool is used to shave off the growth, often under local anesthesia. It's a routine, safe process to maintain skin health.

20 services20 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

20 services20 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 11622

This procedure involves the careful removal of a cancerous skin growth measuring between 1.1 to 2.0 cm, located on the scalp, neck, hands, or feet. The goal is to eliminate the cancer and prevent its spread. This is done under local anesthesia to minimize discomfort.

18 services18 patients

Punch biopsy, each additional skin growth 11105

A punch biopsy is a procedure where a small, circular tool removes a sample of your skin growth. This allows for testing to identify the nature of the growth. If there are multiple growths, each additional one may also need a biopsy.

17 services11 patients

Shaving of skin growth of body, arms, or legs, 0.5 cm or less 11300

This is a simple procedure where a small skin growth on your body, arms, or legs, measuring 0.5 cm or less, is carefully shaved off. It's typically quick, with minimal discomfort. It helps to prevent any potential health issues related to the growth.

16 services16 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less 11305

This is a procedure where a small skin growth on the scalp, neck, hands, or feet, measuring 0.5 cm or less, is carefully removed. The process involves shaving off the growth layer by layer to ensure complete removal. It's a safe and common practice.

13 services13 patients

Simple or single drainage of skin abscess 10060

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

12 services12 patients

Complicated repair of wound of trunk, 2.6-7.5 cm 13101

This service involves the intricate repair of a wound on your body's main structure, between your neck and limbs. The wound measures 2.6-7.5 cm. The procedure includes deep-layer stitching and may involve repairing damaged tissue.

12 services11 patients

All potassium hydroxide (koh) preparations Q0112

Potassium hydroxide (KOH) preparations are used in medical testing to identify fungal infections. In this procedure, a sample (like skin, hair, or nail) is collected and treated with KOH solution. This destroys non-fungal cells, making it easier to spot fungi under a microscope.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33919 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$73.00 typical visit price

range $18.44 – $144.68

Typical copayment $18.25 (range $4.61 – $36.17)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Other Providers at the Same Location NPPES 12

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

FORT MYERS DERMATOPATHOLOGY PA

Dermatology (Dermatopathology)

8381 RIVERWALK PARK BLVD, SUITE 202
FT MYERS, FL 33919

Lee County (239) 274-0005

SHARI L SKINNER M.D.

Dermatology (Procedural Dermatology)

8381 RIVERWALK PARK BLVD, SUITE 101
FORT MYERS, FL 33919

Lee County (239) 936-5425

JULISSA GONZALEZ ARNP

Nurse Practitioner (Pediatrics)

8381 RIVERWALK PARK BLVD, SUITE 202
FORT MYERS, FL 33919

Lee County (239) 689-5561

KEITH M BENBENISTY M.D.

Dermatology (Procedural Dermatology)

8381 RIVERWALK PARK BLVD, SUITE 101
FORT MYERS, FL 33919

Lee County (239) 936-5425

MARVIN S PORTER M.D.

Dermatology (Procedural Dermatology)

8381 RIVERWALK PARK BLVD, SUITE 101
FORT MYERS, FL 33919

Lee County (239) 936-5425

VISION HEALTH CARE GROUP INC

Internal Medicine (Sleep Medicine)

8381 RIVERWALK PARK BLVD, SUITE 201
FORT MYERS, FL 33919

Lee County (239) 466-2030

ANNA J. MCCAUGHNA N.P.

Nurse Practitioner (Family)

8381 RIVERWALK PARK BLVD
FT MYERS, FL 33919

Lee County (239) 274-0005

ANTHONY F FRANSWAY M.D.

Dermatology (Procedural Dermatology)

8381 RIVERWALK PARK BLVD, SUITE 101
FORT MYERS, FL 33919

Lee County (239) 936-5425

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 Laertes Manuelidis's NPI number?

The NPI number for Laertes Manuelidis is 1245220698. It was assigned to this individual provider in the NPPES registry on October 26, 2005.

Where is Laertes Manuelidis located?

Laertes Manuelidis practices at 8381 Riverwalk Park Blvd Suite 1, Fort Myers, FL 33919. The listed phone number is (239) 936-5425.

What is Laertes Manuelidis's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Laertes Manuelidis enrolled in Medicare?

Yes. Laertes Manuelidis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Laertes Manuelidis accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Laertes Manuelidis 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 Laertes Manuelidis was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days 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.