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DIRECT DERMATOLOGY PROFESSIONALS PC
NPI 1417263922
Dermatology in Manteca, CA

Active since August 20, 2010
165 SAINT DOMINICS DR STE 120, MANTECA, CA 95337(510) 241-2884(800) 572-0683 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Direct Dermatology Professionals Pc NPPES

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

DIRECT DERMATOLOGY PROFESSIONALS PC (NPI 1417263922) is a healthcare organization registered as a dermatology in Manteca, California and active in the NPI registry since August 2010. The organization maintains 5 additional practice locations and lists David Wong, President, as its authorized official.

NPPES Registry Identity

NPI1417263922
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDIRECT DERMATOLOGY PROFESSIONALS PC
Location Address165 SAINT DOMINICS DR STE 120Manteca, CA 95337-7802
Mailing Address3000 El Camino Real Ste 4-200Palo Alto, CA 94306-2108 · (510) 241-2884 · Fax (800) 572-0683
Phone(510) 241-2884
Fax(800) 572-0683
Organization SubpartNo
Authorized OfficialDavid WongPresident · (510) 241-2884
Enumeration DateAugust 20, 2010
Last NPPES UpdateJune 17, 2026
NPPES CertifiedJune 17, 2026
✔ NPI 1417263922 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.
165 SAINT DOMINICS DR STE 120, Manteca, CA 95337
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Secondary Practice Locations 5

Location 1632 E Romie LnSalinas, CA 93901-4206 · Phone (510) 241-2884 · Fax (800) 572-0683
Location 28100 Timberlake Way Ste FSacramento, CA 95823-5409 · Phone (510) 241-2884 · Fax (800) 572-0683
Location 3450 E Yosemite Ave Ste AMerced, CA 95340-8429 · Phone (510) 241-2884 · Fax (800) 572-0683
Location 4311 W I StLos Banos, CA 93635-3479 · Phone (510) 241-2884 · Fax (800) 572-0683
Location 5347 E Barstow Ave Ste 104Fresno, CA 93710-6039 · Phone (510) 241-2884 · Fax (800) 572-0683

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Direct Dermatology Professionals Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Direct Dermatology Professionals PC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians by Medicare Specialty 2

Dermatology11
Pathology1

Clinicians, nearest first (12)

Melissa Reyes, M.D.
Dermatology
NPI 1558561498
4050 DUBLIN BLVD
Dublin, CA 94568
(925) 875-6100
✔ PECOS35 mi
Eon Rios, MD
Dermatology
NPI 1942526389
300 PASTEUR DR
Stanford, CA 94305
(650) 723-4000
✔ PECOS✔ Accepts Medicare57 mi
Chen Wang, MD
Dermatology
NPI 1801280359
300 PASTEUR DR
Stanford, CA 94305
(650) 723-4000
✔ PECOS✔ Accepts Medicare57 mi
David Wong, MD, PHD
Dermatology
NPI 1316972201
300 PASTEUR DR
Stanford, CA 94305
(650) 723-4000
✔ PECOS✔ Accepts Medicare57 mi
Reynold Wong, MD
Dermatology
NPI 1962581694
1600 EUREKA RD
Roseville, CA 95661
(916) 784-4000
✔ PECOS✔ Accepts Medicare65 mi
Belinda Tan, MD
Pathology
NPI 1861690299
3870 DEL AMO BLVD UNIT 507
Torrance, CA 90503
(310) 222-6510
✔ PECOS317 mi
Reyhaneh Hamidi, MD
Dermatology
NPI 1144470162
4201 TORRANCE BLVD SUITE 640
Torrance, CA 90503
(310) 543-4444
✔ PECOS✔ Accepts Medicare318 mi
Noah Craft, M.D.
Dermatology
NPI 1750351193
3640 LOMITA BLVD STE 301
Torrance, CA 90505
(310) 405-0693
✔ PECOS✔ Accepts Medicare319 mi
Consuelo Veronica David, M.D.
Dermatology
NPI 1689963340
3640 LOMITA BLVD STE 301
Torrance, CA 90505
(310) 405-0693
✔ PECOS✔ Accepts Medicare319 mi
Reza Kafi, MD
Dermatology
NPI 1891737201
417 SW 117TH AVE STE 100
Portland, OR 97225
(503) 216-8980
✔ PECOS✔ Accepts Medicare539 mi
David Berk, MD
Dermatology
NPI 1205045192
4921 PARKVIEW PL SUITE 5B
Saint Louis, MO 63110
(314) 362-2643
✔ PECOS✔ Accepts Medicare1,679 mi
Julie Lin, MD
Dermatology
NPI 1063572907
53 FAIRFAX RD STE 2
Saint Albans, VT 05478
(833) 688-3376
✔ PECOS✔ Accepts Medicare2,515 mi

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 Direct Dermatology Professionals PC's NPI number?

The NPI number for Direct Dermatology Professionals PC is 1417263922. It was assigned to this organization in the NPPES registry on August 20, 2010.

Where is Direct Dermatology Professionals PC located?

Direct Dermatology Professionals PC is located at 165 Saint Dominics Dr Ste 120, Manteca, CA 95337. The listed phone number is (510) 241-2884.

What is Direct Dermatology Professionals PC's specialty?

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

Is Direct Dermatology Professionals PC enrolled in Medicare?

Yes. Direct Dermatology Professionals PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Direct Dermatology Professionals PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 2 Medicare specialties reassign their Medicare billing to Direct Dermatology Professionals PC. 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. The largest specialties are Dermatology (11) and Pathology (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Direct Dermatology Professionals PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Direct Dermatology Professionals PC 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 Direct Dermatology Professionals PC was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.