Novato Dermatology Associates a Medical Corporation
NPI 1003960063 · Dermatology Physician · Novato, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Novato Dermatology Associates a Medical Corporation is a Dermatology Physician organization in Novato, CA (NPI 1003960063).
Provider details
- NPI number
- 1003960063
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kim Frederickson, Owner(415) 892-0754
- License
- G79619 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-01-23
- Last updated
- 2018-11-08
Frequently asked questions
- What is Novato Dermatology Associates a Medical Corporation's NPI number?
- Novato Dermatology Associates a Medical Corporation's National Provider Identifier (NPI) is 1003960063, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Novato Dermatology Associates a Medical Corporation?
- Novato Dermatology Associates a Medical Corporation is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Novato Dermatology Associates a Medical Corporation located?
- Novato Dermatology Associates a Medical Corporation's practice location on file with NPPES is 867 Diablo Ave, Novato, CA 94947-4007.
- What is Novato Dermatology Associates a Medical Corporation's phone number?
- The practice phone number listed in the NPPES registry for Novato Dermatology Associates a Medical Corporation is (415) 892-0754.
- Does Novato Dermatology Associates a Medical Corporation accept Medicare?
- Novato Dermatology Associates a Medical Corporation is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Novato Dermatology Associates a Medical Corporation?
- The authorized official listed on Novato Dermatology Associates a Medical Corporation's NPPES record is Kim Frederickson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Novato Dermatology Associates a Medical Corporation's NPI active?
- Yes — Novato Dermatology Associates a Medical Corporation's NPI (1003960063) is active in the NPPES registry as of the last update on 2018-11-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.