Prairie Dermatology, PLLC
NPI 1881333680ActiveOrganization· Dermatology· Bloomington, IL
Dermatology in Bloomington, Illinois, registered in NPPES in May 2022. The authorized official on file is Caitlyn Stoewer, PA, Physician Assistant. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1881333680 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 31, 2022 |
| Last updated in NPPES | Mar 9, 2026 |
| Certified by provider | Mar 9, 2026 |
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 (IL) |
|---|
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