Minden Dermatology – Dermatology Physician, NPI 1306623749

Minden Dermatology is a healthcare provider. based in Minden, Nevada. specializing in Dermatology Physician. The NPI Number for Minden Dermatology is 1306623749

Main info

Organization
Name
Minden Dermatology
NPI
1306623749
Phone
(775) 782-0700
Address
1661 LUCERNE ST
Authorized Official
LISA ANN VANDIVER OFFICE MANAGER
Enumeration Date
11 September 2023
Last Update Date
19 July 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness80
Years active:2State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Minden Dermatology

  • 1661 LUCERNE ST

    MINDEN, NV 894234381

    Phone: (775) 782-0700

    Fax: (778) 782-0500

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20231129000043OClinic/Group PracticeNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89423)

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Reviews

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Frequently asked questions

What federal number belongs to Minden Dermatology?
The federal identifier for Minden Dermatology is NPI 1306623749.
Is Minden Dermatology's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does Minden Dermatology treat or focus on?
Patients typically see Minden Dermatology under the specialty Dermatology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Minden Dermatology?
The page summarizes Minden, Nevada for Minden Dermatology; expand the address list for detail.
How can I contact Minden Dermatology?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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