Regional Dermatology PLLC
NPI 1255851200ActiveOrganization· Dermatology, MOHS-Micrographic Surgery· Lexington, KY
Dermatology, MOHS-Micrographic Surgery in Lexington, Kentucky, registered in NPPES in June 2017. The authorized official on file is Samuel J. Pruden, MD, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255851200 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 21, 2017 |
| Last updated in NPPES | Jul 21, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology, MOHS-Micrographic Surgery Primary | 207ND0101X | 34192 | KY |
| Dermatology, Dermatopathology | 207ND0900X | 34192 | KY |
| Otolaryngology | 207Y00000X | 34192 | KY |
| Plastic Surgery | 208200000X | 34192 | KY |
| Physician Assistant, Medical | 363AM0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (KY) |
|---|
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