Novato Dermatology Associates A Medical Corporation
NPI 1003960063ActiveOrganization· Dermatology· Novato, CA
Dermatology in Novato, California, registered in NPPES in January 2007. The authorized official on file is Kim S. Frederickson, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003960063 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 23, 2007 |
| Last updated in NPPES | Nov 8, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | G79619 | CA |
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 (CA) |
|---|
Other Dermatology providers in Novato
- 1053318824
- 1003995291