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UNIVERSITY DERMATOLOGY CENTER PC
NPI 1578615266
Specialist in Muncie, IN

Active since January 16, 2007CLIA Certified · 2 labs
2525 W UNIVERSITY AVE STE 402, MUNCIE, IN 47303(765) 747-6090(765) 747-5069 Get Directions Write a Review

NPPES record last updated: February 19, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About University Dermatology Center Pc NPPES

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

UNIVERSITY DERMATOLOGY CENTER PC (NPI 1578615266) is a healthcare organization registered as a specialist in Muncie, Indiana and active in the NPI registry since January 2007. The organization holds 2 active CLIA laboratory certificates and lists Alexander Zemtsov, Owner, as its authorized official.

NPPES Registry Identity

NPI1578615266
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameUNIVERSITY DERMATOLOGY CENTER PC
Location Address2525 W UNIVERSITY AVE STE 402Muncie, IN 47303-3409
Mailing Address3500 W Purdue AveMuncie, IN 47304-6357 · (765) 747-6090 · Fax (765) 747-5069
Phone(765) 747-6090
Fax(765) 747-5069
Organization SubpartNo
Authorized OfficialAlexander ZemtsovOwner · (765) 747-6090
Enumeration DateJanuary 16, 2007
Last NPPES UpdateFebruary 19, 2024
NPPES CertifiedFebruary 19, 2024
✔ NPI 1578615266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in IN · 50003770A
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2525 W UNIVERSITY AVE STE 402, Muncie, IN 47303
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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 and more.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)

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

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to University Dermatology Center PC, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Julia Bouse, NP
Nurse Practitioner
NPI 1649044520
3500 W PURDUE AVE
Muncie, IN 47304
(765) 747-6090
✔ PECOS✔ Accepts Medicare2.0 mi
Sarah Nocco, MD
Dermatology
NPI 1649807280
3500 W PURDUE AVE
Muncie, IN 47304
(765) 747-6090
✔ PECOS✔ Accepts Medicare2.0 mi
Lisa Wilson, M.D.
Dermatology
NPI 1336223833
3500 W PURDUE AVE
Muncie, IN 47304
(765) 747-6090
✔ PECOS✔ Accepts Medicare2.0 mi
Alexander Zemtsov, MD
Dermatology
NPI 1811901184
3500 W PURDUE AVE
Muncie, IN 47304
(765) 747-6090
✔ PECOS✔ Accepts Medicare2.0 mi
Jeffrey Wargo, MD
Dermatology
NPI 1720217615
830 SIM HODGIN PKWY
Richmond, IN 47374
(765) 939-7664
✔ PECOS✔ Accepts Medicare37 mi
Ann Logan, MD
Radiation Oncology
NPI 1437244597
8244 EAST US 36
Avon, IN 46123
(317) 272-3636
✔ PECOS✔ Accepts Medicare59 mi
John Marvel, MD
Radiation Oncology
NPI 1265432173
1616 SMITH ST
Logansport, IN 46947
(574) 722-3650
✔ PECOS✔ Accepts Medicare63 mi
David Feser
Nurse Practitioner
NPI 1801534144
7450 HOSPITAL DR STE 370
Dublin, OH 43016
(614) 760-1401
✔ PECOS✔ Accepts Medicare119 mi
Inyoung Kim, MD, PHD
Dermatology
NPI 1730567264
737 N MICHIGAN AVE STE 720
Chicago, IL 60611
(312) 319-1978
✔ PECOS✔ Accepts Medicare164 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 15D0898102

University Dermatology Center PC · Muncie, IN
Active · expires Apr 14, 2028
CLIA Number15D0898102
Laboratory TypePhysician Office
Certificate Effective DateApril 15, 2026
Certificate Expiration DateApril 14, 2028
Laboratory DirectorAlexander Zemtsov
Laboratory Phone(765) 747-6090
Laboratory LocationUniversity Dermatology Center PC3500 W Purdue Ave, Muncie, IN 47304
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 15D1012312

University Dermatology Center PC · Richmond, IN
Active · expires Nov 14, 2027
CLIA Number15D1012312
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2025
Certificate Expiration DateNovember 14, 2027
Laboratory DirectorAlexander Zemtsov
Laboratory Phone(765) 747-6090
Laboratory LocationUniversity Dermatology Center PC830 Sim Hodgin Parkway, Richmond, IN 47374
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 University Dermatology Center PC's NPI number?

The NPI number for University Dermatology Center PC is 1578615266. It was assigned to this organization in the NPPES registry on January 16, 2007.

Where is University Dermatology Center PC located?

University Dermatology Center PC is located at 2525 W University Ave Ste 402, Muncie, IN 47303. The listed phone number is (765) 747-6090.

What is University Dermatology Center PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is University Dermatology Center PC enrolled in Medicare?

Yes. University Dermatology Center PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through University Dermatology Center PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to University Dermatology Center 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 (5), Nurse Practitioner (2) and Radiation Oncology (2). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does University Dermatology Center PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does University Dermatology Center PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Cigna Healthcare list University Dermatology Center 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 University Dermatology Center PC was last updated on February 19, 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.