Advanced Dermatology of the Black Hills, PC
NPI 1669125241ActiveOrganization· Physician Assistant· Rapid City, SD
Physician Assistant in Rapid City, South Dakota, registered in NPPES in February 2022. The authorized official on file is Jonathan Dean Medeck, PA-C, Owner/Physician's Assistant.
Overview
| NPI | 1669125241 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 2, 2022 |
| Last updated in NPPES | Feb 2, 2022 |
| Certified by provider | Feb 2, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
| Dermatology | 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 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 |
|---|
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