Waterside Dermatology PLLC
NPI 1639856297ActiveOrganization· Dermatology· Bradenton, FL
Dermatology in Bradenton, Florida, registered in NPPES in July 2023. The authorized official on file is Erfon Ekhlassi, MD, Owner And Physician. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1639856297 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 5, 2023 |
| Last updated in NPPES | Mar 5, 2025 |
| Certified by provider | Mar 5, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
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 (FL) |
|---|
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