Adult and Pediatric Dermatology Practitioners P A
NPI 1417620469ActiveOrganization· Specialist· Port St Lucie, FL
Specialist in Port St Lucie, Florida, registered in NPPES in July 2021. The authorized official on file is Jeffrey T. Masessa, President.
Overview
| NPI | 1417620469 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 27, 2021 |
| Last updated in NPPES | Jul 27, 2021 |
| Certified by provider | Jul 27, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Specialist providers in Port St Lucie
- 1366744997
- 1831273309
- 1497913214
- 1104853498
- 1932329471
- 1437382421
- 1215123781
- 1205387891
- 1013945179
- 1730378712
- 1619016607
- 1871757815