East Tennessee Medical and Surgical Dermatology
NPI 1356975106 · Medical Specialty Clinic/Center · Johnson City, TN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
East Tennessee Medical and Surgical Dermatology is a Medical Specialty Clinic/Center organization in Johnson City, TN (NPI 1356975106).
Provider details
- NPI number
- 1356975106
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stuart Leicht, Physician(423) 262-0112
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
- 2020-03-02
- Last updated
- 2020-07-15
- Certified
- 2020-07-15
Frequently asked questions
- What is East Tennessee Medical and Surgical Dermatology's NPI number?
- East Tennessee Medical and Surgical Dermatology's National Provider Identifier (NPI) is 1356975106, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is East Tennessee Medical and Surgical Dermatology?
- East Tennessee Medical and Surgical Dermatology is classified in the NPPES registry as Medical Specialty Clinic/Center (Ambulatory Health Care Facilities).
- Where is East Tennessee Medical and Surgical Dermatology located?
- East Tennessee Medical and Surgical Dermatology's practice location on file with NPPES is 2898 Boones Creek Rd Ste 105, Johnson City, TN 37615-4976.
- What is East Tennessee Medical and Surgical Dermatology's phone number?
- The practice phone number listed in the NPPES registry for East Tennessee Medical and Surgical Dermatology is (423) 262-0112.
- Does East Tennessee Medical and Surgical Dermatology accept Medicare?
- East Tennessee Medical and Surgical Dermatology 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 East Tennessee Medical and Surgical Dermatology?
- The authorized official listed on East Tennessee Medical and Surgical Dermatology's NPPES record is Stuart Leicht, Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is East Tennessee Medical and Surgical Dermatology's NPI active?
- Yes — East Tennessee Medical and Surgical Dermatology's NPI (1356975106) is active in the NPPES registry as of the last update on 2020-07-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.