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PHELAN DERMATOLOGY & AESTHETICS
NPI 1942881677
Dermatology in Joplin, MO

Active since April 15, 2021CLIA 26D2152564 · Certificate of Compliance
520 E 32ND ST, JOPLIN, MO 64804(417) 622-0293(833) 275-1784 Get Directions Write a Review

NPPES record last updated: December 24, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 24, 2024, Dec 18, 2024, Sep 20, 2022 and 1 more (4 updates tracked since 2021).

About Phelan Dermatology & Aesthetics NPPES

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

PHELAN DERMATOLOGY & AESTHETICS (NPI 1942881677) is a healthcare organization registered as a dermatology in Joplin, Missouri and active in the NPI registry since April 2021. The organization holds a CLIA Certificate of Compliance certificate valid through September 3, 2028, maintains a secondary practice location in Pineville, and lists Jorge Martinez, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1942881677
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePHELAN DERMATOLOGY & AESTHETICS
Location Address520 E 32ND STJoplin, MO 64804-3904
Mailing Address520 E 32nd StJoplin, MO 64804-3904 · (417) 622-0293 · Fax (833) 275-1784
Phone(417) 622-0293
Fax(833) 275-1784
Organization SubpartNo
Authorized OfficialJorge MartinezPractice Administrator · (417) 622-0293
Enumeration DateApril 15, 2021
Last NPPES UpdateDecember 24, 20244 updates tracked since enumeration
NPPES CertifiedDecember 24, 2024
✔ NPI 1942881677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
520 E 32ND ST, Joplin, MO 64804
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Secondary Practice Location 1

Location 121088 US Business Highway 71, #7Pineville, MO 64856 · Phone (417) 622-0293 · Fax (833) 275-1784

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phelan Dermatology & Aesthetics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Phelan Dermatology & Aesthetics, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Nathaniel Phelan, MD
Dermatology
NPI 1225327422
520 E 32ND ST
Joplin, MO 64804
(417) 622-0293
✔ PECOS✔ Accepts MedicareSame address
Brett Neill, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1679006522
3850 S NATIONAL AVE STE 705
Springfield, MO 65807
(417) 888-0858
✔ PECOS✔ Accepts Medicare68 mi
Jeremy Light, MD
Dermatology
NPI 1831727718
109 PINEHURST DR
Branson, MO 65616
(417) 888-0858
✔ PECOS✔ Accepts Medicare75 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 26D2152564

Phelan Dermatology & Aesthetics · Joplin, MO
Active · expires Sep 3, 2028
CLIA Number26D2152564
Laboratory TypePhysician Office
Certificate Effective DateSeptember 4, 2026
Certificate Expiration DateSeptember 3, 2028
Laboratory DirectorNathaniel M. Phelan
Laboratory Phone(417) 622-0293
Laboratory LocationPhelan Dermatology & Aesthetics520 E 32nd St, Joplin, MO 64804
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 Phelan Dermatology & Aesthetics's NPI number?

The NPI number for Phelan Dermatology & Aesthetics is 1942881677. It was assigned to this organization in the NPPES registry on April 15, 2021.

Where is Phelan Dermatology & Aesthetics located?

Phelan Dermatology & Aesthetics is located at 520 E 32nd St, Joplin, MO 64804. The listed phone number is (417) 622-0293.

What is Phelan Dermatology & Aesthetics's specialty?

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

Is Phelan Dermatology & Aesthetics enrolled in Medicare?

Yes. Phelan Dermatology & Aesthetics is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Phelan Dermatology & Aesthetics?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Phelan Dermatology & Aesthetics, in Dermatology and Micrographic Dermatologic Surgery (MDS). 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Phelan Dermatology & Aesthetics hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 26D2152564) is associated with this NPI, valid through September 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Phelan Dermatology & Aesthetics accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Phelan Dermatology & Aesthetics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phelan Dermatology & Aesthetics was last updated on December 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.