LIVE OAK DERMATOLOGY PC
NPI 1609654466
Dermatology - MOHS-Micrographic Surgery in Fairview, PA
NPI Status: Active since September 21, 2023
Contact Information
7176 W RIDGE RD
FAIRVIEW, PA
ZIP 16415
Phone: (814) 413-7997
Fax: (814) 413-7998
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- CLIA Number: 39D2301108
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 03-18-2027
About LIVE OAK DERMATOLOGY PC
This page provides the complete NPI Profile along with additional information for Live Oak Dermatology Pc, a provider established in Fairview, Pennsylvania operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1609654466 assigned on September 2023. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated one year 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 Dr. Michael Zaycosky Do (Owner)
- NPI
- 1609654466
- Provider Name
- LIVE OAK DERMATOLOGY PC
- Entity Type
- Organization
- Location Address
- 7176 W RIDGE RD FAIRVIEW, PA 16415
- Location Phone
- (814) 413-7997
- Location Fax
- (814) 413-7998
- Mailing Address
- 7176 W RIDGE RD FAIRVIEW, PA 16415
- Mailing Phone
- (814) 413-7997
- Mailing Fax
- (814) 413-7998
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-21-2023
- Last Update Date
- 01-30-2025
- Code Navigator
Location Map
Secondary Locations
- 118 E Plum St
Edinboro, PA 16412
(814) 413-7997
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
- 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:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| OS015047 | OTHER (01) | PA | STATE LIC |
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
- 39D2301108
- Facility Type
- Practitioner Other
- Certificate Effective Date
- March 19, 2025
- Certificate Expiration Date
- March 18, 2027
- Laboratory Director
- DR. MICHAEL B. ZAYCOSKY
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Live Oak Dermatology Pc 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.
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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 1609654466, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609654466, enumerated as an "organization" on September 21, 2023.
The provider is located at 7176 W RIDGE RD FAIRVIEW, PA 16415 and the phone number is (814) 413-7997.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
