LIGHTHOUSE DERMATOLOGY AND SKIN CANCER SPECIALISTS
NPI 1689413445
Dermatology - MOHS-Micrographic Surgery in Saint Clair Shores, MI

NPI Status: Active since May 22, 2024

Contact Information

26901 HARPER AVE
SAINT CLAIR SHORES, MI
ZIP 48081
Phone: (248) 726-7646

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  • Organization
  • Dermatology
  • MOHS-Micrographic Surgery
  • Accepts Insurance
  • CLIA Number: 23D2308467
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-17-2027

About LIGHTHOUSE DERMATOLOGY AND SKIN CANCER SPECIALISTS

This page provides the complete NPI Profile along with additional information for Lighthouse Dermatology And Skin Cancer Specialists, a provider established in Saint Clair Shores, Michigan operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1689413445 assigned on May 2024. 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 Rachel Escobar Np (Office Manager)

NPI
1689413445
Provider Name
LIGHTHOUSE DERMATOLOGY AND SKIN CANCER SPECIALISTS
Entity Type
Organization
Location Address
26901 HARPER AVE SAINT CLAIR SHORES, MI 48081
Location Phone
(248) 726-7646
Mailing Address
6363 29 MILE RD WASHINGTON, MI 48095
Mailing Phone
(586) 381-8775
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-22-2024
Last Update Date
04-18-2025
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Location Map

Secondary Locations

  • 20 W Clarkston Rd
    Lake Orion, MI 48362
    (248) 726-7646

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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207N00000XAllopathic & Osteopathic Physicians

Dermatology

 

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:

  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Select HMO Bronze Saver HSA - HMO
  • Blue Cross� Select HMO Bronze Secure - HMO
  • Blue Cross� Select HMO Silver - HMO
  • Blue Cross� Select HMO Silver Extra - HMO
  • Blue Cross� Select HMO Silver Saver - HMO
  • Blue Cross� Select HMO Value - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze Saver HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RACHEL ESCOBAR NP

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(248) 726-7646

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
23D2308467
Facility Type
Physician Office
Certificate Effective Date
June 18, 2025
Certificate Expiration Date
June 17, 2027
Laboratory Director
MIGUEL A. HERRERA-MARTINEZ
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Lighthouse Dermatology And Skin Cancer Specialists 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 1689413445, we treat the final digit (5) 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 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

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.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
9
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
4
Unchanged
Pos 9
4
Doubled → 8
Check
5
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 8 → 16 → 7 4 → 8 3 → 6 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 6 + 9 + 8 + 1 + 6 + 4 + 8 + 24 = 75

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1689413445.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Internal Medicine
26901 HARPER AVE
SAINT CLAIR SHORES, MI 48081
Dermatology
26901 HARPER AVE
SAINT CLAIR SHORES, MI 48081
Dermatology
26901 HARPER AVE
SAINT CLAIR SHORES, MI 48081

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689413445, enumerated as an "organization" on May 22, 2024.

The provider is located at 26901 HARPER AVE SAINT CLAIR SHORES, MI 48081 and the phone number is (248) 726-7646.

Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.

The provider might be accepting Accepts: Blue Care Network of Michigan and Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.