1. Home
  2. Directory
  3. Washington
  4. Bonney Lake
  5. Dermatology
  6. NPI Profile

INNOVATIVE WOUND HEALING & DERMATOLOGY
NPI 1538741053
Dermatology in Bonney Lake, WA

Active since April 23, 2021
21137 SR 410 E STE I, BONNEY LAKE, WA 98391(800) 425-2805(855) 673-1403 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 16, 2024, Jul 6, 2023, Feb 16, 2023 and 3 more (6 updates tracked since 2021).

About Innovative Wound Healing & Dermatology NPPES

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

INNOVATIVE WOUND HEALING & DERMATOLOGY (NPI 1538741053) is a healthcare organization registered as a dermatology in Bonney Lake, Washington and active in the NPI registry since April 2021. The organization maintains a secondary practice location in San Antonio and lists Daniel Levy, Provider, as its authorized official.

NPPES Registry Identity

NPI1538741053
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINNOVATIVE WOUND HEALING & DERMATOLOGY
Location Address21137 SR 410 E STE IBonney Lake, WA 98391-8775
Mailing Address21137 Sr 410 E Ste IBonney Lake, WA 98391-8775 · (800) 425-2805 · Fax (855) 673-1403
Phone(800) 425-2805
Fax(855) 673-1403
Organization SubpartNo
Authorized OfficialDaniel LevyProvider · (800) 425-2805
Enumeration DateApril 23, 2021
Last NPPES UpdateSeptember 16, 20246 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2024
✔ NPI 1538741053 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.
21137 SR 410 E STE I, Bonney Lake, WA 98391
Open in Google Maps ↗

Secondary Practice Location 1

Location 1414 Babcock RdSan Antonio, TX 78201-3120 · Phone (800) 494-7759 · Fax (253) 750-5151

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 Blue Cross and Blue Shield of Texas, Premera Blue Cross Blue Shield of Alaska.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)

Innovative Wound Healing & Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Innovative Wound Healing & Dermatology, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Zachary Stanfield, DPM
Podiatry
NPI 1588010359
10004 204TH AVE E STE 2700
Bonney Lake, WA 98391
(253) 862-1967
✔ PECOS✔ Accepts Medicare0.4 mi
Daniel Levy, MD
Dermatology
NPI 1306067814
21137 STATE ROUTE 410 E STE I
Bonney Lake, WA 98391
(253) 862-5275
✔ PECOS✔ Accepts Medicare0.7 mi
Lance Nethercott, D.P.M.
Podiatry
NPI 1891119129
2728 E MAIN STE A
Puyallup, WA 98372
(253) 848-0131
✔ PECOS✔ Accepts Medicare4.7 mi
Quyen Stevenson, ARNP
Nurse Practitioner
NPI 1497988505
1660 S COLUMBIAN WAY
Seattle, WA 98108
(206) 762-1010
✔ PECOS✔ Accepts Medicare28 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 Innovative Wound Healing & Dermatology's NPI number?

The NPI number for Innovative Wound Healing & Dermatology is 1538741053. It was assigned to this organization in the NPPES registry on April 23, 2021.

Where is Innovative Wound Healing & Dermatology located?

Innovative Wound Healing & Dermatology is located at 21137 Sr 410 E Ste I, Bonney Lake, WA 98391. The listed phone number is (800) 425-2805.

What is Innovative Wound Healing & Dermatology's specialty?

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

Is Innovative Wound Healing & Dermatology enrolled in Medicare?

Yes. Innovative Wound Healing & Dermatology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Innovative Wound Healing & Dermatology?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Innovative Wound Healing & Dermatology, in Dermatology, Nurse Practitioner and Podiatry. 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. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Innovative Wound Healing & Dermatology accept?

Health plans from Blue Cross and Blue Shield of Texas and Premera Blue Cross Blue Shield of Alaska list Innovative Wound Healing & Dermatology 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 Innovative Wound Healing & Dermatology was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.