Integrated Dermatology of Enfield, LLC
NPI 1134544661ActiveOrganization· Dermatology· Simsbury, CT
Dermatology in Simsbury, Connecticut, registered in NPPES in February 2014. The authorized official on file is Jeffrey D. Queen, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1134544661 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 20, 2014 |
| Last updated in NPPES | Jun 11, 2025 |
| Certified by provider | Jun 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Specialist | 174400000X | — | — |
| Physician Assistant | 363A00000X | — | — |
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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