KENT P ELLERBROEK MD PC
NPI 1346403755
Dermatology - MOHS-Micrographic Surgery in Waterloo, IA
NPI Status: Active since July 07, 2008
Contact Information
541 KING DR
WATERLOO, IA
ZIP 50702
Phone: (319) 235-6323
Fax: (319) 235-0249
- Organization
- Dermatology
- MOHS-Micrographic Surgery
About KENT P ELLERBROEK MD PC
This page provides the complete NPI Profile along with additional information for Kent P Ellerbroek Md Pc, a provider established in Waterloo, Iowa operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1346403755 assigned on July 2008. The practitioner's primary taxonomy code is 207ND0101X with license number 202213 (IA). The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Kent P Ellerbroek M.d. (Medical Doctor)
- NPI
- 1346403755
- Provider Name
- KENT P ELLERBROEK MD PC
- Entity Type
- Organization
- Location Address
- 541 KING DR WATERLOO, IA 50702
- Location Phone
- (319) 235-6323
- Location Fax
- (319) 235-0249
- Mailing Address
- 541 KING DR WATERLOO, IA 50702
- Mailing Phone
- (319) 235-6323
- Mailing Fax
- (319) 235-0249
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-07-2008
- Last Update Date
- 10-14-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 202213
- License State
- IA
- Taxonomy Description
- The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| DN2700 | MEDICARE PIN (08) | IA | |
| 16980 | MEDICARE PIN (08) | IA |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 4 | 6 | 4 | 0 | 3 | 7 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 8 | 6 | 8 | 0 | 6 | 7 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 8 + 6 + 8 + 0 + 6 + 7 + 1 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1346403755 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1104800192 | MR. KENT P ELLERBROEK MD Individual | Dermatology | 541 KING DR WATERLOO, IA 50702 (319) 235-6323 |
| 1013284488 | DR. BRADY HAKEMAN D.C. Individual | Chiropractor | 541 KING DR WATERLOO, IA 50702 (319) 233-9717 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1346403755, enumerated in the NPI registry as an "organization" on July 07, 2008
The provider is located at 541 King Dr Waterloo, Ia 50702 and the phone number is (319) 235-6323
This medical organization specializes in Dermatology with taxonomy code 207ND0101X with a focus in MOHS-Micrographic Surgery
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on July 07, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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