BAUCOM & MINA DERM SURGERY, LLC
NPI 1245780980
Dermatology - MOHS-Micrographic Surgery in Atlanta, GA

NPI Status: Active since October 06, 2016

Contact Information

5555 PEACHTREE DUNWOODY RD
SUITE 206
ATLANTA, GA
ZIP 30342
Phone: (404) 844-0496
Fax: (404) 844-0499

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  • Organization
  • Dermatology
  • MOHS-Micrographic Surgery
  • Accepts Insurance
  • CLIA Number: 11D0906008
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-13-2027

About BAUCOM & MINA DERM SURGERY, LLC

This page provides the complete NPI Profile along with additional information for Baucom & Mina Derm Surgery, Llc, a provider established in Atlanta, Georgia operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1245780980 assigned on October 2016. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mary Alice Mina M.d. (Owner)

NPI
1245780980
Provider Name
BAUCOM & MINA DERM SURGERY, LLC
Entity Type
Organization
Location Address
5555 PEACHTREE DUNWOODY RD SUITE 206 ATLANTA, GA 30342
Location Phone
(404) 844-0496
Location Fax
(404) 844-0499
Mailing Address
5555 PEACHTREE DUNWOODY RD SUITE 206 ATLANTA, GA 30342
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-06-2016
Last Update Date
12-13-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology MOHS-Micrographic Surgery

Taxonomy Code
207ND0101X
Type
Allopathic & Osteopathic Physicians
License State
GA
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Thrive Silver - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARY ALICE MINA M.D.

Authorized Official Title
OWNER
Authorized Official Phone
(404) 844-0496

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D0906008
Facility Type
Physician Office
Certificate Effective Date
November 14, 2025
Certificate Expiration Date
November 13, 2027
Laboratory Director
MARK F. BAUCOM
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Baucom & Mina Derm Surgery, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

Reviews for BAUCOM & MINA DERM SURGERY, LLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1245780980, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
4
Doubled → 8
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
9
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 7 → 14 → 5 0 → 0 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 8 + 5 + 1 + 4 + 8 + 0 + 9 + 1 + 6 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1245780980.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Occupational Therapist
5555 PEACHTREE DUNWOODY RD
ATLANTA, GA 30342
Ophthalmology
5555 PEACHTREE DUNWOODY RD, STE 256
ATLANTA, GA 30342
Physician Assistant
5555 PEACHTREE DUNWOODY RD, STE 190
ATLANTA, GA 30342
Pain Medicine (Interventional Pain Medicine)
5555 PEACHTREE DUNWOODY RD, STE G99
ATLANTA, GA 30342
Orthopaedic Surgery
5555 PEACHTREE DUNWOODY RD, STE. 215
ATLANTA, GA 30342
Audiologist
5555 PEACHTREE DUNWOODY RD, G-51
ATLANTA, GA 30342
Physical Therapist
5555 PEACHTREE DUNWOODY RD, ST 225
ATLANTA, GA 30342
Psychiatry & Neurology (Child & Adolescent Psychiatry)
5555 PEACHTREE DUNWOODY RD, SUITE 330
ATLANTA, GA 30342
Pediatrics
5555 PEACHTREE DUNWOODY RD, SUITE 130
ATLANTA, GA 30342
Physical Therapist
5555 PEACHTREE DUNWOODY RD, SUITE 225
ATLANTA, GA 30342
Dentist (Orthodontics and Dentofacial Orthopedics)
5555 PEACHTREE DUNWOODY RD, SUITE 301
ATLANTA, GA 30342
Physical Therapist
5555 PEACHTREE DUNWOODY RD, SUITE 225
ATLANTA, GA 30342
Otolaryngology
5555 PEACHTREE DUNWOODY RD, STE 125
ATLANTA, GA 30342
Physical Therapist
5555 PEACHTREE DUNWOODY RD, SUITE 225
ATLANTA, GA 30342
Occupational Therapist
5555 PEACHTREE DUNWOODY RD, SUITE 225
ATLANTA, GA 30342
Nurse Practitioner (Family)
5555 PEACHTREE DUNWOODY RD
SANDY SPRINGS, GA 30342
Colon & Rectal Surgery
5555 PEACHTREE DUNWOODY RD, SUITE 206
ATLANTA, GA 30342
Pharmacy (Community/Retail Pharmacy)
5555 PEACHTREE DUNWOODY RD
ATLANTA, GA 30342
Dermatology (MOHS-Micrographic Surgery)
5555 PEACHTREE DUNWOODY RD, SUITE 206
ATLANTA, GA 30342
Clinic/Center (Ambulatory Surgical)
5555 PEACHTREE DUNWOODY RD, SUITE G99
ATLANTA, GA 30342

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245780980, enumerated as an "organization" on October 06, 2016.

The provider is located at 5555 PEACHTREE DUNWOODY RD SUITE 206 ATLANTA, GA 30342 and the phone number is (404) 844-0496.

Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.