SOUTHEASTERN DERMATOLOGY, PA
NPI 1841229036
Specialist in Tallahassee, FL

NPI Status: Active since July 01, 2006

Contact Information

2040 FLEISCHMANN RD
TALLAHASSEE, FL
ZIP 32308
Phone: (850) 422-3376
Fax: (850) 205-7182

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  • Organization
  • Specialist
  • CLIA Number: 10D2059743
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 05-29-2027

About SOUTHEASTERN DERMATOLOGY, PA

This page provides the complete NPI Profile along with additional information for Southeastern Dermatology, Pa, a provider established in Tallahassee, Florida operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1841229036 assigned on July 2006. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 10 years 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 Dr. Michael J Ford Md (Medical Director)

NPI
1841229036
Provider Name
SOUTHEASTERN DERMATOLOGY, PA
Entity Type
Organization
Location Address
2040 FLEISCHMANN RD TALLAHASSEE, FL 32308
Location Phone
(850) 422-3376
Location Fax
(850) 205-7182
Mailing Address
2040 FLEISCHMANN RD TALLAHASSEE, FL 32308
Mailing Phone
(850) 422-3376
Mailing Fax
(850) 205-7182
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-01-2006
Last Update Date
06-14-2016
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Location Map

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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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:

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

DR. MICHAEL J FORD MD

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(850) 422-3376

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
K2914MEDICARE PIN (08)FL 
10D0992605OTHER (01)FLCLIA
000595501MEDICAID (05)FL 

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
10D2059743
Facility Type
Physician Office
Certificate Effective Date
May 30, 2025
Certificate Expiration Date
May 29, 2027
Laboratory Director
MICHAEL J. FORD
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Southeastern Dermatology, Pa in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate 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 1841229036, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

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
8
Unchanged
Pos 3
4
Doubled → 8
Pos 4
1
Unchanged
Pos 5
2
Doubled → 4
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
0
Unchanged
Pos 9
3
Doubled → 6
Check
6
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 4 → 8 2 → 4 9 → 18 → 9 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 8 + 1 + 4 + 2 + 1 + 8 + 0 + 6 + 24 = 64

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

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1841229036.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
2040 FLEISCHMANN RD
TALLAHASSEE, FL 32308
Physician Assistant (Medical)
2040 FLEISCHMANN RD
TALLAHASSEE, FL 32308
Physician Assistant (Medical)
2040 FLEISCHMANN RD
TALLAHASSEE, FL 32308
Physician Assistant
2040 FLEISCHMANN RD
TALLAHASSEE, FL 32308

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1841229036, enumerated as an "organization" on July 01, 2006.

The provider is located at 2040 FLEISCHMANN RD TALLAHASSEE, FL 32308 and the phone number is (850) 422-3376.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.