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LIVE OAK DERMATOLOGY PC
NPI 1609654466
Dermatology - MOHS-Micrographic Surgery in Fairview, PA

Active since September 21, 2023CLIA 39D2301108 · Certificate of Compliance
7176 W RIDGE RD, FAIRVIEW, PA 16415(814) 413-7997(814) 413-7998 Get Directions Write a Review

NPPES record last updated: January 30, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Live Oak Dermatology Pc NPPES

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

LIVE OAK DERMATOLOGY PC (NPI 1609654466) is a healthcare organization registered as a mohs-micrographic surgery in Fairview, Pennsylvania and active in the NPI registry since September 2023. The organization holds a CLIA Certificate of Compliance certificate valid through March 18, 2027, maintains a secondary practice location in Edinboro, and lists Michael Zaycosky, Owner, as its authorized official.

NPPES Registry Identity

NPI1609654466
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameLIVE OAK DERMATOLOGY PC
Location Address7176 W RIDGE RDFairview, PA 16415-2027
Mailing Address7176 W Ridge RdFairview, PA 16415-2027 · (814) 413-7997 · Fax (814) 413-7998
Phone(814) 413-7997
Fax(814) 413-7998
Organization SubpartNo
Authorized OfficialMichael ZaycoskyOwner · (814) 413-7997
Enumeration DateSeptember 21, 2023
Last NPPES UpdateJanuary 30, 2025
NPPES CertifiedJanuary 30, 2025
✔ NPI 1609654466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
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.
7176 W RIDGE RD, Fairview, PA 16415
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Secondary Practice Location 1

Location 1118 E Plum StEdinboro, PA 16412-2252 · Phone (814) 413-7997 · Fax (814) 413-7998

Other Identifiers 1

OtherOS015047PA · State Lic

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

CLIA Laboratory Certificates CMS CLIA

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 39D2301108

Live Oak Dermatology PC · Fairview, PA
Active · expires Mar 18, 2027
CLIA Number39D2301108
Laboratory TypePractitioner Other
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorDr. Michael B. Zaycosky
Laboratory Phone(814) 413-7997
Laboratory LocationLive Oak Dermatology PC7176 West Ridge Road, Fairview, PA 16415
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.

Other Providers at the Same Location NPPES 4

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

MS. ANDREA RENEE BURNS CRNP
Nurse Practitioner (Family)
7176 W RIDGE RD
FAIRVIEW, PA 16415
Erie County (814) 474-3613
DR. MICHAEL BRIAN ZAYCOSKY D.O.
Dermatology
7176 W RIDGE RD
FAIRVIEW, PA 16415
Erie County (814) 413-7997
THOMAS H TURNER MD
Family Medicine
7176 W RIDGE RD
FAIRVIEW, PA 16415
Erie County (814) 474-3613
THOMAS H TURNER MD
Family Medicine
7176 W RIDGE RD
FAIRVIEW, PA 16415
Erie County (814) 474-3613

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 Live Oak Dermatology PC's NPI number?

The NPI number for Live Oak Dermatology PC is 1609654466. It was assigned to this organization in the NPPES registry on September 21, 2023.

Where is Live Oak Dermatology PC located?

Live Oak Dermatology PC is located at 7176 W Ridge Rd, Fairview, PA 16415. The listed phone number is (814) 413-7997.

What is Live Oak Dermatology PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Live Oak Dermatology PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 39D2301108) is associated with this NPI, valid through March 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Live Oak Dermatology PC was last updated on January 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.