Emerald Coast Dermatology & Skin Surgery Center P a
NPI 1386639912 · Dermatology Physician · Crestview, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Emerald Coast Dermatology & Skin Surgery Center P a is a Dermatology Physician organization in Crestview, FL (NPI 1386639912).
Provider details
- NPI number
- 1386639912
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jillian Owens, Credentialing and Contracting(850) 689-1740
- License
- ME0061435 (FL)
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
20 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
- 2005-09-20
- Last updated
- 2026-01-20
- Certified
- 2026-01-20
Frequently asked questions
- What is Emerald Coast Dermatology & Skin Surgery Center P a's NPI number?
- Emerald Coast Dermatology & Skin Surgery Center P a's National Provider Identifier (NPI) is 1386639912, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Emerald Coast Dermatology & Skin Surgery Center P a?
- Emerald Coast Dermatology & Skin Surgery Center P a is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Emerald Coast Dermatology & Skin Surgery Center P a located?
- Emerald Coast Dermatology & Skin Surgery Center P a's practice location on file with NPPES is 350 Redstone Ave W, Crestview, FL 32536-6433.
- What is Emerald Coast Dermatology & Skin Surgery Center P a's phone number?
- The practice phone number listed in the NPPES registry for Emerald Coast Dermatology & Skin Surgery Center P a is (850) 689-1740.
- Does Emerald Coast Dermatology & Skin Surgery Center P a accept Medicare?
- Emerald Coast Dermatology & Skin Surgery Center 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 Emerald Coast Dermatology & Skin Surgery Center P a?
- The authorized official listed on Emerald Coast Dermatology & Skin Surgery Center P a's NPPES record is Jillian Owens, Credentialing and Contracting. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Emerald Coast Dermatology & Skin Surgery Center P a's NPI active?
- Yes — Emerald Coast Dermatology & Skin Surgery Center P a's NPI (1386639912) is active in the NPPES registry as of the last update on 2026-01-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.