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PAN DERMATOLOGY, PC
NPI 1821164096
Dermatology - Dermatopathology in Colonie, NY

Active since November 28, 2006CLIA 33D1062706 · Certificate of Compliance
105 EVERETT RD, COLONIE, NY 12205(518) 694-0999 Get Directions Write a Review

NPPES record last updated: February 17, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Pan Dermatology, Pc NPPES

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

PAN DERMATOLOGY, PC (NPI 1821164096) is a healthcare organization registered as a dermatopathology in Colonie, New York and active in the NPI registry since November 2006. The organization holds a CLIA Certificate of Compliance certificate valid through November 30, 2026 and lists Teddy D Pan, Principal Owner, as its authorized official.

NPPES Registry Identity

NPI1821164096
Entity TypeOrganization
Primary Taxonomy207ND0900X
Legal Business NamePAN DERMATOLOGY, PC
Location Address105 EVERETT RDColonie, NY 12205-1407
Mailing Address105 Everett RdColonie, NY 12205-1407 · (518) 694-0999
Phone(518) 694-0999
Organization SubpartNo
Authorized OfficialTeddy D PanPrincipal Owner · (518) 694-0999
Enumeration DateNovember 28, 2006
Last NPPES UpdateFebruary 17, 2017
✔ NPI 1821164096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · DermatopathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ND0900X
License✔ Licensed in NY · 239724-1
Definition
A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
105 EVERETT RD, Colonie, NY 12205
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Other Identifiers 1

Medicare PINBA1038NY

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pan Dermatology, Pc 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 Pan Dermatology, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Teddy Pan, MD
Dermatology
NPI 1609847979
105 EVERETT RD
Colonie, NY 12205
(518) 694-0999
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D1062706

Pan Dermatology, PC · Colonie, NY
Active · expires Nov 30, 2026
CLIA Number33D1062706
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorDr. Teddy D. Pan
Laboratory Phone(518) 694-0999
Laboratory LocationPan Dermatology, PC105 Everett Rd, Colonie, NY 12205
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Pan Dermatology, PC's NPI number?

The NPI number for Pan Dermatology, PC is 1821164096. It was assigned to this organization in the NPPES registry on November 28, 2006.

Where is Pan Dermatology, PC located?

Pan Dermatology, PC is located at 105 Everett Rd, Colonie, NY 12205. The listed phone number is (518) 694-0999.

What is Pan Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

Is Pan Dermatology, PC enrolled in Medicare?

Yes. Pan Dermatology, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pan Dermatology, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Pan Dermatology, PC. 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.

Does Pan Dermatology, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 33D1062706) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pan Dermatology, PC was last updated on February 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.