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NPI · 1366431769 · NPPES-sourced

Coastal Dermatology PA

ActiveDermatology
NPI Number
1366431769
Type 2 · Organisation
Taxonomy Code
207N00000X
Contact
(904) 727-9123
Primary practice line
Last Updated
About 11 years ago (May 2015)
Enumerated 2005-10-18
Primary practice addressFL · 32246-3776
2804 Saint Johns Bluff Rd S, Ste 109Jacksonville, FL 32246-3776
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About this NPIWhat this record shows.

NPI 1366431769 is registered to Coastal Dermatology PA, a healthcare organisation classified as "Dermatology" and located at 2804 Saint Johns Bluff Rd S, Ste 109 in Jacksonville, Florida. The organisation's authorised official is Sanjiva Goyal. The organisation has been enumerated in the NPI registry since 2005.

Provider type
Organisation (Type 2)
Status
Active
Enumerated
2005-10-18
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Secondary identifiers

Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.

Other

  • 35493ZFL· Issued by MEDICARE PROVIDER ID
  • K3994FL· Issued by MEDICARE PTAN

Source: NPPES public registry.

Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Part B Supplier

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Coastal Dermatology PA accepts. To confirm in-network status with your specific health plan, contact Coastal Dermatology PA directly at (904) 727-9123.

Frequently asked

Yes. NPI 1366431769 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Dermatology is a medical specialty focused on conditions affecting the skin, hair, and nails, including acne, eczema, psoriasis, skin cancer screenings, and cosmetic procedures.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (904) 727-9123.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Coastal Dermatology PA is a Type-2 organisational NPI.

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Quick facts

Provider typeOrganisation
Taxonomy207N00000X
Last updated2015-05
Enumerated2005-10-18
StatusActive
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