BONDURANT DERMATOLOGY, PLC
NPI 1902636558
Dermatology in Bondurant, IA

Active since August 07, 2024
88 PAINE CIR STE 4, BONDURANT, IA 50035(515) 348-6383(515) 348-6437 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 20, 2024, Aug 7, 2024 (2 updates tracked since 2024).

About Bondurant Dermatology, Plc NPPES

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

BONDURANT DERMATOLOGY, PLC (NPI 1902636558) is a healthcare organization registered as a dermatology in Bondurant, Iowa and active in the NPI registry since August 2024. The organization lists Susan Peden, Owner, as its authorized official.

NPPES Registry Identity

NPI1902636558
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBONDURANT DERMATOLOGY, PLC
Location Address88 PAINE CIR STE 4Bondurant, IA 50035-1449
Mailing Address88 Paine Cir Ste 4Bondurant, IA 50035-1449 · (515) 348-6383 · Fax (515) 348-6437
Fax(515) 348-6437
Organization SubpartNo
Authorized OfficialSusan PedenOwner · (515) 205-4571
Enumeration DateAugust 7, 2024
Last NPPES UpdateNovember 20, 20242 updates tracked since enumeration
NPPES CertifiedNovember 20, 2024
✔ NPI 1902636558 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.
88 PAINE CIR STE 4, Bondurant, IA 50035

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)

Bondurant Dermatology, Plc 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 Bondurant Dermatology, Plc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nurse Practitioner
NPI 1356834113
88 PAINE CIR STE 4
Bondurant, IA 50035
(515) 348-6383
✔ 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 Bondurant Dermatology, Plc's NPI number?

The NPI number for Bondurant Dermatology, Plc is 1902636558. It was assigned to this organization in the NPPES registry on August 7, 2024.

Where is Bondurant Dermatology, Plc located?

Bondurant Dermatology, Plc is located at 88 Paine Cir Ste 4, Bondurant, IA 50035. The listed phone number is (515) 348-6383.

What is Bondurant Dermatology, Plc's specialty?

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

Is Bondurant Dermatology, Plc enrolled in Medicare?

Yes. Bondurant Dermatology, Plc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bondurant Dermatology, Plc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Bondurant Dermatology, Plc. 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.

When was this NPI record last updated?

The NPPES record for Bondurant Dermatology, Plc was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.