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GENESIS DERMATOLOGY
NPI 1659144111
Dermatology in La Grande, OR

Active since November 06, 2023
1902 4TH ST STE 3, LA GRANDE, OR 97850(541) 663-0007(541) 663-0010 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Genesis Dermatology NPPES

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

GENESIS DERMATOLOGY (NPI 1659144111) is a healthcare organization registered as a dermatology in La Grande, Oregon and active in the NPI registry since November 2023. The organization lists Bryce A Earle, Chief Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1659144111
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameGENESIS DERMATOLOGY
Location Address1902 4TH ST STE 3La Grande, OR 97850-2558
Mailing Address1902 4th St Ste 3La Grande, OR 97850-2558 · (541) 663-0007 · Fax (541) 663-0010
Phone(541) 663-0007
Fax(541) 663-0010
Organization SubpartNo
Authorized OfficialBryce A EarleChief Operations Manager · (541) 663-0007
Enumeration DateNovember 6, 2023
NPPES CertifiedNovember 6, 2023
✔ NPI 1659144111 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.
1902 4TH ST STE 3, La Grande, OR 97850
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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 BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.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)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Genesis Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Heather Earle, ARNP
Nurse Practitioner
NPI 1700939683
1902 4TH ST STE 3
La Grande, OR 97850
(541) 663-0007
✔ PECOS✔ Accepts MedicareSame address

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 Genesis Dermatology's NPI number?

The NPI number for Genesis Dermatology is 1659144111. It was assigned to this organization in the NPPES registry on November 6, 2023.

Where is Genesis Dermatology located?

Genesis Dermatology is located at 1902 4th St Ste 3, La Grande, OR 97850. The listed phone number is (541) 663-0007.

What is Genesis Dermatology's specialty?

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

Is Genesis Dermatology enrolled in Medicare?

Yes. Genesis Dermatology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Genesis Dermatology?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Genesis Dermatology. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Genesis Dermatology accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Genesis 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 Genesis Dermatology was last updated on November 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.