TAREEN DERMATOLOGY, P.A. (NPI# 1063782621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063782621 |
| Entity Type | Organization |
| Organization Name | TAREEN DERMATOLOGY, P.A. |
| Practice Address |
1835 County Road C W 250 Roseville MN 55113-1352 |
| Practice Telephone | 6516336883 |
| Practice Fax Number | 6515286276 |
| Mailing Telephone | 6516336883 |
| Mailing Fax Number | 6515286276 |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2019-03-25 |
| Authorized Official Name | MOHIBA K TAREEN (OWNER) |
| Authorized Official Telephone | 7345461760 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 207N00000X | Dermatology | 54002 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
1835 COUNTY ROAD C W 250 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588630925 | Derek Allen Moline | Optometrist | 1835 County Road C W, Suite 140, Roseville, MN 55113-1352 | 2006-02-26 |
| 1518493170 | North Memorial Health Care | Clinic/Center | 1835 County Road C W, #150, Roseville, MN 55113-1352 | 2017-05-02 |
| 1366899437 | Chloe Ferrar | Physician Assistant | 1835 County Road C W, Roseville, MN 55113-1352 | 2016-05-18 |
| 1598125064 | Lauren H Massopust | Physician Assistant | 1835 County Road C W, 150, Roseville, MN 55113-1352 | 2016-02-26 |
| 1811356397 | Jeremiah Lynch | Physician Assistant | 1835 County Road C W, Roseville, MN 55113-1352 | 2016-02-12 |
| 1104201284 | Pdg, Pa | Clinic/Center | 1835 County Road C W, Suite 200, Roseville, MN 55113 | 2015-07-30 |
| 1477950475 | Kelsey L Holmes | Physician Assistant | 1835 County Road C W, 250, Roseville, MN 55113-1352 | 2014-11-20 |
| 1578822599 | Hunter Hendry Piermont | Student in an Organized Health Care Education/Training Program | 1835 County Road C W, Suite 220, Roseville, MN 55113-1352 | 2012-05-11 |
| 1801152814 | Amdahl Hearing, Inc. | Clinic/Center | 1835 County Road C W, Ste. 80, Roseville, MN 55113-1352 | 2012-04-03 |
| 1558659615 | Jason Michael Prostrollo | Pediatrics | 1835 County Road C W, Roseville, MN 55113-1352 | 2011-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1740411628 | Javier Rangel | Dermatology | 2120 Professional Dr # 140, Roseville, CA 95661-3700 | 2009-07-27 |
| 1598981763 | Kathryn Boyse Gant | Dermatology | 258 Gibson Dr, Ste 140, Roseville, CA 95678-5881 | 2007-04-17 |
| 1548366727 | Scott B Hearth | Dermatology | 1535 Eureka Rd, Roseville, CA 95661-3040 | 2006-09-15 |
| 1255447215 | Usha R Sood | Dermatology | 18285 Ten Mile Rd, Suite 130, Roseville, MI 48066 | 2006-08-22 |
| 1114940343 | Robert Hadley Hargrove | Dermatology | 10 Sierra Gate Plz Ste 120, Roseville, CA 95678-6647 | 2006-07-26 |
| 1508803263 | Roseville Dermatology Inc. | Dermatology | 1211 Pleasant Grove Blvd, Suite 100, Roseville, CA 95678-6971 | 2006-06-01 |
| 1629051677 | Adam Adair Pettey | Dermatology | 2120 Professional Dr, Roseville, CA 95661-3700 | 2005-11-23 |
| 1184628000 | Gregory Michael Bricca | Dermatology | 9269 Sierra College Blvd, Roseville, CA 95661 | 2005-06-09 |
| 1003327545 | West Oak Dermatology Inc | Dermatology | 258 Gibson Dr, Ste 140, Roseville, CA 95678-5881 | 2017-10-23 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.