Cardinal Dermatology LLC
NPI 1174390926ActiveOrganization· Dermatology· South Bend, IN
Dermatology in South Bend, Indiana, registered in NPPES in December 2023. The authorized official on file is Luiz Carlos Pantalena Filho, MD, PHD, Member. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1174390926 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 11, 2023 |
| Last updated in NPPES | Jan 2, 2025 |
| Certified by provider | Dec 31, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — | — |
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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