Mountain Pine Dermatology, PLLC
NPI 1659827665ActiveOrganization· Dermatology· Meridian, ID
Dermatology in Meridian, Idaho, registered in NPPES in August 2016. The authorized official on file is Richard Scott Thomas, D.O., Owner. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1659827665 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 30, 2016 |
| Last updated in NPPES | Jul 5, 2020 |
| Certified by provider | Jul 5, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | O-0934 | ID |
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); Part B Supplier - Clinic/Group Practice (OR) |
|---|
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