KENT P ELLERBROEK MD PC (NPI# 1346403755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346403755 |
| Entity Type | Organization |
| Organization Name | KENT P ELLERBROEK MD PC |
| Practice Address |
541 King Dr Waterloo IA 50702-5959 |
| Practice Telephone | 3192356323 |
| Practice Fax Number | 3192350249 |
| Mailing Telephone | 3192356323 |
| Mailing Fax Number | 3192350249 |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-10-14 |
| Authorized Official Name | DR. KENT P ELLERBROEK (MEDICAL DOCTOR) |
| Authorized Official Telephone | 3192356323 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
202213 | IA | Allopathic & Osteopathic Physicians |
| Street Address |
541 KING DR |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702-5959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104800192 | Kent P Ellerbroek | Dermatology | 541 King Dr, Waterloo, IA 50702-5959 | 2005-12-02 |
| 1013284488 | Brady Hakeman | Chiropractor | 541 King Dr, Waterloo, IA 50702-5959 | 2011-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| 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. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922245638 | John Perrotto, D.o., P.a. | Dermatology | 5910 Ashworth Rd # 134, West Des Moines, IA 50266-7108 | 2009-01-16 |
| 1477076628 | Forefront Dermatology, S.c. | Dermatology | 12327 Stratford Dr, Clive, IA 50325 | 2017-07-19 |
| 1316342611 | Forefront Dermatology, S.c. | Dermatology | 202 10th St Se Ste 270, Cedar Rapids, IA 52403 | 2014-10-29 |
| 1912103979 | Dermatology Associates LLP | Dermatology | 501 12th Ave, Suite 101, Coralville, IA 52241-1774 | 2007-06-26 |
| 1477506814 | Hobart W Walling | Dermatology | 1100 6th St, Suite 202, Coralville, IA 52241-1755 | 2006-05-18 |
| 1992758122 | Roger I Ceilley | Dermatology | 6000 University Ave, Suite 450, West Des Moines, IA 50266-8203 | 2006-05-18 |
| 1790736353 | Dermatology, PC | Dermatology | 6000 University Ave, Suite 450, West Des Moines, IA 50266-8203 | 2006-05-16 |
Please comment or provide details below to improve the information on KENT P ELLERBROEK MD PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.