IHA DERMATOLOGIC SURGERY ASSOCIATES
NPI 1629121256
Dermatology - MOHS-Micrographic Surgery in Ypsilanti, MI
NPI Status: Active since January 18, 2007
Contact Information
4990 W CLARK RD
BLDG A SUITE 200
YPSILANTI, MI
ZIP 48197
Phone: (734) 572-7500
Fax: (734) 572-7777
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- Accepts Insurance
- CLIA Number: 23D1063292
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-20-2025
About IHA DERMATOLOGIC SURGERY ASSOCIATES
This page provides the complete NPI Profile along with additional information for Iha Dermatologic Surgery Associates, a provider established in Ypsilanti, Michigan operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1629121256 assigned on January 2007. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Iha Dermatologic Surgery Associates operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Iha Dermatologic Surgery Associates. The authorized official of this NPI record is Cynthia A Elliott (Vp/chief Operating Officer)
- NPI
- 1629121256
- Provider Legal Name
- IHA HEALTH SERVICES CORPORATION
- Other Organization Name
- IHA DERMATOLOGIC SURGERY ASSOCIATES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4990 W CLARK RD BLDG A SUITE 200 YPSILANTI, MI 48197
- Location Phone
- (734) 572-7500
- Location Fax
- (734) 572-7777
- Mailing Address
- 24 FRANK LLOYD WRIGHT DR P.O. BOX 0446, LOBBY J ANN ARBOR, MI 48105
- Mailing Phone
- (734) 747-6766
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-18-2007
- Last Update Date
- 04-01-2011
- 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
- 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 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
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 |
|---|---|---|---|
| M32310 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI | MEDICARE GROUP NUMBER |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D1063292
- Facility Type
- Physician Office
- Certificate Effective Date
- November 21, 2023
- Certificate Expiration Date
- November 20, 2025
- Laboratory Director
- MONTGOMERY O. GILLARD
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Iha Dermatologic Surgery Associates after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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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 | 6 | 2 | 9 | 1 | 2 | 1 | 2 | 5 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 2 | 2 | 2 | 2 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 2 + 2 + 2 + 2 + 1 + 0 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1629121256 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1083761696 | IHA HEALTH SERVICES CORPORATION Organization | Obstetrics & Gynecology (Gynecology) | 4990 W CLARK RD SUITE 400 YPSILANTI, MI 48197 (734) 572-5756 |
| 1033380878 | IHA HEALTH SERVICES CORPORATION Organization | Nurse Anesthetist, Certified Registered | 4990 W CLARK RD SUITE 200 YPSILANTI, MI 48197 (734) 572-7500 |
| 1710111075 | IHA OF ANN ARBOR PC Organization | Clinic/Center (Ambulatory Surgical) | 4990 W CLARK RD SUITE 500 YPSILANTI, MI 48197 (734) 572-7500 |
| 1336296946 | IHA HEALTH SERVICES CORPORATION Organization | Radiology (Body Imaging) | 4990 W CLARK RD SUITE 300 YPSILANTI, MI 48197 (734) 434-0539 |
| 1194051003 | IHA HEALTH SERVICES CORPORATION Organization | Clinic/Center (Radiology) | 4990 W CLARK RD SUITE 300 YPSILANTI, MI 48197 (734) 434-0539 |
| 1164858221 | IHA HEALTH SERVICES CORPORATION Organization | Dermatology | 4990 W CLARK RD STE 400 YPSILANTI, MI 48197 (734) 677-3376 |
| 1134124217 | MONTGOMERY O GILLARD MD Individual | Dermatology (MOHS-Micrographic Surgery) | 4990 W CLARK RD BUILDING A, SUITE 200 YPSILANTI, MI 48197 (734) 572-7500 |
| 1235352311 | APRIL L MARQUARDT MD Individual | Internal Medicine (Rheumatology) | 4990 W CLARK RD SUITE 300 YPSILANTI, MI 48197 (734) 593-5990 |
| 1912224841 | ERIC LEE WISE M.D. Individual | Internal Medicine (Rheumatology) | 4990 W CLARK RD SUITE 300 YPSILANTI, MI 48197 (734) 593-5990 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629121256, enumerated in the NPI registry as an "organization" on January 18, 2007
The provider is located at 4990 W Clark Rd Bldg A Suite 200 Ypsilanti, Mi 48197 and the phone number is (734) 572-7500
This medical organization specializes in Dermatology with taxonomy code 207ND0101X with a focus in MOHS-Micrographic Surgery
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 23D1063292 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on January 18, 2007. 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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