Medderm Corporation
NPI 1063447936 · Dermatology Physician · San Diego, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Medderm Corporation is a Dermatology Physician organization in San Diego, CA (NPI 1063447936).
Provider details
- NPI number
- 1063447936
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michelle Pelle, Owner/Director(619) 542-0013
- License
- A88009 (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
Other names (DBA / former)
- Doing business as
- Medderm Associates
Registry dates
- Enumerated
- 2006-07-11
- Last updated
- 2023-04-18
- Certified
- 2023-04-18
Frequently asked questions
- What is Medderm Corporation's NPI number?
- Medderm Corporation's National Provider Identifier (NPI) is 1063447936, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Medderm Corporation?
- Medderm Corporation is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Medderm Corporation located?
- Medderm Corporation's practice location on file with NPPES is 3965 5th Ave Ste 200, San Diego, CA 92103-3107.
- What is Medderm Corporation's phone number?
- The practice phone number listed in the NPPES registry for Medderm Corporation is (619) 542-0013.
- Does Medderm Corporation accept Medicare?
- Medderm 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 Medderm Corporation?
- The authorized official listed on Medderm Corporation's NPPES record is Michelle Pelle, Owner/Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Medderm Corporation's NPI active?
- Yes — Medderm Corporation's NPI (1063447936) is active in the NPPES registry as of the last update on 2023-04-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.