DERMATOLOGY SURGERY CENTER
NPI 1700822335
Clinic/Center - Ambulatory Surgical in Tyler, TX

NPI Status: Active since June 21, 2006

Contact Information

1367 DOMINION PLAZA
TYLER, TX
ZIP 75703
Phone: (903) 534-6200
Fax: (903) 939-0755

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 45D1011220
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 01-01-2027

About DERMATOLOGY SURGERY CENTER

This page provides the complete NPI Profile along with additional information for Dermatology Surgery Center, a provider established in Tyler, Texas operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1700822335 assigned on June 2006. The practitioner's primary taxonomy code is 261QA1903X with license number 007937 (TX). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Dermatology Surgery Center. The authorized official of this NPI record is Ms. Andrea Lynne Stein Rn (Practice Administrator)

NPI
1700822335
Provider Legal Name
OLIVER STREET DERMATOLOGY ASC LLC
Other Organization Name
DERMATOLOGY SURGERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1367 DOMINION PLAZA TYLER, TX 75703
Location Phone
(903) 534-6200
Location Fax
(903) 939-0755
Mailing Address
1367 DOMINION PLAZA TYLER, TX 75703
Mailing Phone
(903) 534-6200
Mailing Fax
(903) 939-0755
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-21-2006
Last Update Date
02-06-2013
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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

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
007937
License State
TX

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard+ (Dental + Vision) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Standard - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Silver Standard - HMO
  • UHC Silver Value ($0 Virtual Urgent Care) - HMO
  • UHC Silver Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO

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.

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.

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

MS. ANDREA LYNNE STEIN RN

Authorized Official Title
PRACTICE ADMINISTRATOR
Authorized Official Phone
(903) 534-6200

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
P00044713OTHER (01)TXRAILROAD MEDICARE PTAN
162384501MEDICAID (05)TX 
ASC177MEDICARE PIN (08)TX 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy of related skin growth, first growth

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

This service was performed 16 times for 16 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm

This procedure involves the intricate repair of a wound that is 1.1 to 2.5 cm long on your eyelids, nose, ears, or lip. The goal is to mend the wound carefully to preserve function and minimize scarring. The process may involve stitching and other techniques.

This service was performed 61 times for 60 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm

This procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.

This service was performed 133 times for 132 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size is between 1.1-2.5 cm. This repair may involve multiple layers of sutures and could require reconstruction of the skin.

This service was performed 50 times for 50 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

This service was performed 632 times for 600 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

This service was performed 106 times for 105 patients

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less

A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.

This service was performed 18 times for 17 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

This service was performed 15 times for 15 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

This service was performed 32 times for 32 patients

Repair of wound by transferring skin, 30.1-60.0 sq cm

This procedure involves repairing a wound by moving healthy skin from one area of the body to the wound site. The transferred skin, measuring between 30.1-60.0 square cm, aids in healing and reduces scarring.

This service was performed 37 times for 37 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

This service was performed 272 times for 261 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by transferring skin from another part of the body. The size of the skin transferred will be between 10.1 to 30.0 square centimeters. It is performed to restore function and appearance.

This service was performed 61 times for 61 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on various body parts by transferring skin from another area. The transferred skin, up to 10.0 sq cm, helps to cover the wound, promoting healing and reducing scarring. It's a common method for treating larger or deeper wounds.

This service was performed 46 times for 45 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm

This procedure involves repairing a wound on specified body areas by transferring skin from another part of the body. The transferred skin, measuring between 10.1 to 30.0 square cm, aids in healing the wound and restoring the skin's normal function.

This service was performed 78 times for 77 patients

Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on your scalp, arm, or leg by transferring a small piece of skin, 10.0 sq cm or less, from a different area of your body. This skin graft helps promote healing and minimizes scarring.

This service was performed 24 times for 24 patients

Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm

This procedure involves repairing a wound on your scalp, arm, or leg by moving skin from another part of your body. The skin transferred will cover an area between 10.1 to 30.0 square cm. This helps promote healing and reduce scarring.

This service was performed 47 times for 47 patients

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
45D1011220
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
January 02, 2025
Certificate Expiration Date
January 01, 2027
Laboratory Director
DR. JENNIFER HOLMAN
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Dermatology Surgery Center on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha 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 1700822335, 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 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
7
Unchanged
Pos 3
0
Doubled → 0
Pos 4
0
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
3
Unchanged
Pos 9
3
Doubled → 6
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 0 → 0 8 → 16 → 7 2 → 4 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 0 + 0 + 1 + 6 + 2 + 4 + 3 + 6 + 24 = 55

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

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1700822335.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Dermatology
1367 DOMINION PLAZA
TYLER, TX 75703
Dermatology
1367 DOMINION PLAZA
TYLER, TX 75703
Dermatology
1367 DOMINION PLAZA
TYLER, TX 75703
Dermatology
1367 DOMINION PLAZA
TYLER, TX 75703
Dermatology
1367 DOMINION PLAZA
TYLER, TX 75703

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700822335, enumerated as an "organization" on June 21, 2006.

The provider is located at 1367 DOMINION PLAZA TYLER, TX 75703 and the phone number is (903) 534-6200.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas,. Please consult your insurance carrier or call the provider to verify.