North Bay Dermatology Associates
NPI 1275622664 · Specialist · Petaluma, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
North Bay Dermatology Associates is a Specialist organization in Petaluma, CA (NPI 1275622664).
Provider details
- NPI number
- 1275622664
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Santiago Centurion, Practice Owner(707) 763-6816
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
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)
- Other name
- Glenn A. Koby, MD
- Doing business as
- North Bay Dermatology
Registry dates
- Enumerated
- 2006-10-12
- Last updated
- 2019-06-25
Frequently asked questions
- What is North Bay Dermatology Associates's NPI number?
- North Bay Dermatology Associates's National Provider Identifier (NPI) is 1275622664, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is North Bay Dermatology Associates?
- North Bay Dermatology Associates is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is North Bay Dermatology Associates located?
- North Bay Dermatology Associates's practice location on file with NPPES is 106 Lynch Creek Way, Petaluma, CA 94954-2356.
- What is North Bay Dermatology Associates's phone number?
- The practice phone number listed in the NPPES registry for North Bay Dermatology Associates is (707) 763-6816.
- Does North Bay Dermatology Associates accept Medicare?
- North Bay Dermatology Associates 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 North Bay Dermatology Associates?
- The authorized official listed on North Bay Dermatology Associates's NPPES record is Santiago Centurion, Practice Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is North Bay Dermatology Associates's NPI active?
- Yes — North Bay Dermatology Associates's NPI (1275622664) is active in the NPPES registry as of the last update on 2019-06-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.