Issc Fruitland
NPI 1568112688ActiveOrganization· Dermatology· Fruitland, ID
Dermatology in Fruitland, Idaho, registered in NPPES in March 2022, part of Idaho Skin Surgery Center, PC. The authorized official on file is Celia Ramos, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1568112688 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Idaho Skin Surgery Center, PC |
| NPI issued | Mar 24, 2022 |
| Last updated in NPPES | Jul 16, 2025 |
| Certified by provider | Jul 3, 2025 |
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 (ID) |
|---|
Other Dermatology providers in Fruitland
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- 1558349852
- 1083653489