IDAHO DERMATOLOGIC SURGERY & LASER CENTER PA
NPI 1649478454
Dermatology - MOHS-Micrographic Surgery in Boise, ID

Q: What is Idaho Dermatologic Surgery & Laser Center PA's specialty?

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

Active since July 03, 2007

1488 N KNIGHTS DR, BOISE, ID 83712(208) 345-4050(208) 327-9524 Get Directions Write a Review

NPPES record last updated: February 23, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Idaho Dermatologic Surgery & Laser Center Pa NPPES

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

IDAHO DERMATOLOGIC SURGERY & LASER CENTER PA (NPI 1649478454) is a healthcare organization registered as a mohs-micrographic surgery in Boise, Idaho and active in the NPI registry since July 2007. The organization lists Teri J Cottingham, Owner, as its authorized official.

NPPES Registry Identity

NPI1649478454

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameIDAHO DERMATOLOGIC SURGERY & LASER CENTER PA

Location Address1488 N KNIGHTS DRBoise, ID 83712-6557

Mailing Address967 E Parkcenter Blvd # 142Boise, ID 83706-6721 · (208) 345-4050 · Fax (208) 327-9524

Phone(208) 345-4050

Fax(208) 327-9524

Organization SubpartNo

Authorized OfficialTeri J CottinghamOwner · (208) 869-2869

Enumeration DateJuly 3, 2007

Last NPPES UpdateFebruary 23, 2024

NPPES CertifiedFebruary 23, 2024

✔ NPI 1649478454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in ID · M-7506

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.

Also ListedDermatologyTaxonomy 207N00000X · License M-7506 (ID)

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License M-7506 (ID)

Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X

1488 N KNIGHTS DR, Boise, ID 83712

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Other Identifiers 2

Other1139318ID · Ptan

Medicaid805151100ID

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

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 Idaho Dermatologic Surgery & Laser Center PA's NPI number?

The NPI number for Idaho Dermatologic Surgery & Laser Center PA is 1649478454. It was assigned to this organization in the NPPES registry on July 3, 2007.

Where is Idaho Dermatologic Surgery & Laser Center PA located?

Idaho Dermatologic Surgery & Laser Center PA is located at 1488 N Knights Dr, Boise, ID 83712. The listed phone number is (208) 345-4050.

What is Idaho Dermatologic Surgery & Laser Center PA's specialty?

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

What insurance does Idaho Dermatologic Surgery & Laser Center PA accept?

Health plans from Moda Health Plan, Inc. list Idaho Dermatologic Surgery & Laser Center PA 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 Idaho Dermatologic Surgery & Laser Center PA was last updated on February 23, 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.