Dermatology Inc
NPI 1053421610ActiveOrganization· Dermatology· Greenwood, IN
Dermatology in Greenwood, Indiana, registered in NPPES in August 2006. The authorized official on file is Khristi Autajay, Practice Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053421610 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 30, 2006 |
| Last updated in NPPES | Apr 22, 2025 |
| Certified by provider | Apr 22, 2025 |
| Reactivated | Sep 22, 2022 |
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 (IN) |
|---|
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