Phelan Dermatology & Aesthetics
NPI 1942881677ActiveOrganization· Dermatology· Joplin, MO
Dermatology in Joplin, Missouri, registered in NPPES in April 2021. The authorized official on file is Jorge Martinez, Practice Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1942881677 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 15, 2021 |
| Last updated in NPPES | Dec 24, 2024 |
| Certified by provider | Dec 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — | — |
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 (MO) |
|---|
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