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Organization

Advanced Dermatologic Surgery, P.A.

NPI Record: ActiveDermatology — MOHS-Micrographic Surgery
NPI1003016312
Overland Park, Kansas

Provider's NPPES record last updated: June 3, 2022

Overview

Entity Type
Organization
NPI
1003016312
Primary Specialty
Dermatology — MOHS-Micrographic Surgery
Practice Location
Overland Park, Kansas
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 17, 2026, 9:57 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Dermatology

    MOHS-Micrographic Surgery

    Allopathic & Osteopathic Physicians

    Primary

    The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

    Taxonomy code 207ND0101X
  • Specialist

    Other Service Providers

    An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

    Taxonomy code 174400000X
  • Clinical Medical Laboratory

    Laboratories

    (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

    Taxonomy code 291U00000X

Provider-Reported License Information

Specialist (Kansas)
04-25136
Clinical Medical Laboratory (Kansas)
04-25136
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

6901 W 121st St

Overland Park, Kansas 66209-2007

Phone: (913) 661-1755

Additional Practice Location

6410 N Cosby Ave

Kansas City, Missouri 64151-2377

Phone: (816) 643-4501

Other Names

  • Advanced Dermatologic SurgeryReported June 3, 2022
  • Advanced Dermatologic SurgeryReported July 24, 2007
  • Trinity DermatologyReported June 3, 2022

Record Information

Enumeration Date
July 24, 2007
Provider's NPPES Record Last Updated
June 3, 2022
Certification Date
June 3, 2022
NPISignal NPPES Dataset
August 2026

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