Mountain West Derm - Blackhart PLLC
NPI 1366018848ActiveOrganization· Dermatology· Georgetown, TX
Dermatology in Georgetown, Texas, registered in NPPES in June 2021. The authorized official on file is Bret S. Blackhart, MD, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1366018848 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 3, 2021 |
| Last updated in NPPES | Jun 14, 2021 |
| Certified by provider | Jun 14, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
| Dermatology, Dermatopathology | 207ND0900X | — | — |
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 (TX) |
|---|
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