Silver Falls Dermatology, PC – Dermatology Physician, NPI 1134375421

Silver Falls Dermatology, PC is a healthcare provider. based in Salem, Oregon. specializing in Dermatology Physician. The organization holds a License No. MD26178 (OR). The NPI Number for Silver Falls Dermatology, PC is 1134375421

Main info

Organization
Name
Silver Falls Dermatology, PC
NPI
1134375421
Phone
(503) 362-8385
Address
1793 13TH ST SE
Authorized Official
MALISSA KOBBEVIK CREDENTIALING MANAGER
Enumeration Date
18 August 2008
Last Update Date
17 October 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness80
Years active:17State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Silver Falls Dermatology, PC

  • 1793, 13th Street Southeast, Salem, Marion County, Oregon, 97302, United States

    SALEM, OR 973022541

    Phone: (503) 362-8385

    Fax: (503) 362-8435

    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: 2014-03-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-06-30 (343 days ago).

Enrollment records

2

Earliest due date

2025-06-30

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
O20081009000466OClinic/Group PracticeORTBD
O20140328000678OClinic/Group PracticeWA2025-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 97302)

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Reviews

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Frequently asked questions

What identifier follows Silver Falls Dermatology, PC across health systems?
The NPI 1134375421 uniquely identifies Silver Falls Dermatology, PC in U.S. healthcare data.
Is Silver Falls Dermatology, PC currently accepting referrals based on NPI status?
Registry metadata lists Silver Falls Dermatology, PC as active.
What type of care does Silver Falls Dermatology, PC provide?
Silver Falls Dermatology, PC's profile centers on Dermatology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Silver Falls Dermatology, PC?
Silver Falls Dermatology, PC shows a connection to Salem, Oregon in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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