Elite Dermatology Physicians PLLC
NPI 1003644402ActiveOrganization· Dermatology· New Canaan, CT
Dermatology in New Canaan, Connecticut, registered in NPPES in July 2024. The authorized official on file is Ellen De Moll, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003644402 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 25, 2024 |
| Last updated in NPPES | Jul 25, 2024 |
| Certified by provider | Jul 25, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CT) |
|---|
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