Cardinal Dermatology LLC
NPI 1174390926 · Dermatology Physician · South Bend, IN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Cardinal Dermatology LLC is a Dermatology Physician organization in South Bend, IN (NPI 1174390926).
Provider details
- NPI number
- 1174390926
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Luiz Pantalena Filho, Member(650) 387-9765
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
- 2023-12-11
- Last updated
- 2025-01-02
- Certified
- 2024-12-31
Frequently asked questions
- What is Cardinal Dermatology LLC's NPI number?
- Cardinal Dermatology LLC's National Provider Identifier (NPI) is 1174390926, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Cardinal Dermatology LLC?
- Cardinal Dermatology LLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Cardinal Dermatology LLC located?
- Cardinal Dermatology LLC's practice location on file with NPPES is 4322 Lafayette Blvd, South Bend, IN 46614.
- What is Cardinal Dermatology LLC's phone number?
- The practice phone number listed in the NPPES registry for Cardinal Dermatology LLC is (574) 391-1111.
- Does Cardinal Dermatology LLC accept Medicare?
- Cardinal Dermatology LLC 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 Cardinal Dermatology LLC?
- The authorized official listed on Cardinal Dermatology LLC's NPPES record is Luiz Pantalena Filho, Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Cardinal Dermatology LLC's NPI active?
- Yes — Cardinal Dermatology LLC's NPI (1174390926) is active in the NPPES registry as of the last update on 2025-01-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.