CARLSON SURGICAL DERMATOLOGY CORP
NPI 1912649096
Dermatology in San Francisco, CA

Active since April 10, 2022
2100 WEBSTER ST STE 506, SAN FRANCISCO, CA 94115(415) 226-9431 Get Directions Write a Review

NPPES record last updated: April 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Carlson Surgical Dermatology Corp NPPES

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

CARLSON SURGICAL DERMATOLOGY CORP (NPI 1912649096), doing business as California Center For Dermatologic Surgery, is a healthcare organization registered as a dermatology in San Francisco, California and active in the NPI registry since April 2022. The organization lists Ekama Carlson, Owner, as its authorized official.

NPPES Registry Identity

NPI1912649096
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCARLSON SURGICAL DERMATOLOGY CORP
Location Address2100 WEBSTER ST STE 506San Francisco, CA 94115-2381
Mailing Address2100 Webster St Ste 506San Francisco, CA 94115-2381 · (415) 226-9431
Organization SubpartNo
Authorized OfficialEkama CarlsonOwner · (415) 226-9431
Enumeration DateApril 10, 2022
NPPES CertifiedApril 8, 2022
✔ NPI 1912649096 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.
2100 WEBSTER ST STE 506, San Francisco, CA 94115

Other Names 1

Doing Business AsCalifornia Center For Dermatologic Surgery

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)

Carlson Surgical Dermatology Corp 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 Carlson Surgical Dermatology Corp, which bills Medicare for the services this clinician delivers.

Clinician (1)

Micrographic Dermatologic Surgery (MDS)
NPI 1245532159
2100 WEBSTER ST STE 506
San Francisco, CA 94115
(415) 266-9431
✔ 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.

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 05D2271683

Carlson Surgical Dermatology Corp Dba Ca Ctr For Derm Surgery · San Francisco, CA
Expired · Oct 1, 2026
CLIA Number05D2271683
Laboratory TypeMohs Surgery Lab
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorEkama O. Carlson
Laboratory Phone(415) 226-9431
Laboratory LocationCarlson Surgical Dermatology Corp Dba Ca Ctr For Derm Surgery2100 Webster St, Ste 506, San Francisco, CA 94115
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 Carlson Surgical Dermatology Corp's NPI number?

The NPI number for Carlson Surgical Dermatology Corp is 1912649096. It was assigned to this organization in the NPPES registry on April 10, 2022. The provider is doing business as California Center for Dermatologic Surgery.

Where is Carlson Surgical Dermatology Corp located?

Carlson Surgical Dermatology Corp is located at 2100 Webster St Ste 506, San Francisco, CA 94115. The listed phone number is (415) 226-9431.

What is Carlson Surgical Dermatology Corp's specialty?

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

Is Carlson Surgical Dermatology Corp enrolled in Medicare?

Yes. Carlson Surgical Dermatology Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Carlson Surgical Dermatology Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Micrographic Dermatologic Surgery (MDS)) reassigns their Medicare billing to Carlson Surgical Dermatology Corp. 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 Carlson Surgical Dermatology Corp was last updated on April 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.