Dermatology and Mohs Surgery Associates LLC
NPI 1124689831ActiveOrganization· Dermatology· San Juan, PR
Dermatology in San Juan, Puerto Rico, registered in NPPES in June 2019. The authorized official on file is Roberto Luis Davila - De Pedro, M.D., Dermatologist And Mohs Surgeon. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124689831 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 24, 2019 |
| Last updated in NPPES | Apr 13, 2022 |
| Certified by provider | Apr 13, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (PR) |
|---|
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