Axis Dermatology LLC
NPI 1194658427ActiveOrganization· Dermatology· Peachtree Corners, GA
Dermatology in Peachtree Corners, Georgia, registered in NPPES in June 2026. The authorized official on file is Hasan Khosravi, MD, FAAD, Chief Medical Officer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1194658427 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 5, 2026 |
| Last updated in NPPES | Sep 24, 2026 |
| Certified by provider | Sep 24, 2026 |
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 (GA) |
|---|
Other Dermatology providers in Peachtree Corners
- 1649790627