Southside Dermatology, P.A.
NPI 1023276607 · Specialist · Jacksonville, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southside Dermatology, P.A. is a Specialist organization in Jacksonville, FL (NPI 1023276607).
Provider details
- NPI number
- 1023276607
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Mary Pentel, President(904) 880-0622
- License
- ME16473 (FL)
Specialties & taxonomies
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
- 2008-05-29
- Last updated
- 2014-07-02
Frequently asked questions
- What is Southside Dermatology, P.A.'s NPI number?
- Southside Dermatology, P.A.'s National Provider Identifier (NPI) is 1023276607, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southside Dermatology, P.A.?
- Southside Dermatology, P.A. is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Southside Dermatology, P.A. located?
- Southside Dermatology, P.A.'s practice location on file with NPPES is 4727 Sunbeam Rd, Jacksonville, FL 32257-6107.
- What is Southside Dermatology, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Southside Dermatology, P.A. is (904) 880-0622.
- Does Southside Dermatology, P.A. accept Medicare?
- Southside Dermatology, P.A. 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 Southside Dermatology, P.A.?
- The authorized official listed on Southside Dermatology, P.A.'s NPPES record is Mary Pentel, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southside Dermatology, P.A.'s NPI active?
- Yes — Southside Dermatology, P.A.'s NPI (1023276607) is active in the NPPES registry as of the last update on 2014-07-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.