ADVANCED DERMATOLOGIC SURGERY, P.A.
ADVANCED DERMATOLOGIC SURGERY, P.A. is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1003016312, based in Overland Park, KS. The organization lists 3 taxonomy classifications, with MOHS-Micrographic Surgery Physician recorded as primary.
Getting there
Here is what surrounds this office in Overland Park, based on OpenStreetMap data collected Aug 29, 2026. Parking is available about 526 ft away. There is EV charging 0.46 mi from the office — useful if you are driving in from out of town. The nearest transit stop is 0.41 mi away. If you arrive early, there is a coffee shop 0.34 mi away.
Getting here and what is nearby
Parking 318 ft ~2 min
Parking 475 ft ~2 min
Parking 526 ft ~2 min
Restaurant Schlotzsky's 867 ft ~4 min
Restaurant Fazoli's 979 ft ~4 min
12045 Metcalf Avenue, Overland Park
Restaurant Sonic 0.20 mi ~5 min
12090 Metcalf Avenue, Overland Park 66213
Mo-Fr 06:00-22:00; Sa 07:00-22:00; Su 08:00-22:00
Grocery Pan-Asia Market 0.24 mi ~5 min
Grocery Whole Foods Market 0.33 mi ~7 min
11900 Metcalf Avenue, Overland Park 66213
Mo-Su 08:00-21:00
Coffee Starbucks 0.34 mi ~7 min
Gas station Costco Gasoline 0.39 mi ~8 min
Transit 0.41 mi ~9 min
EV charging ChargePoint 0.41 mi ~9 min
Hotel SpringHill Suites Kansas City Overland Park 0.44 mi ~9 min
Grocery Walmart Supercenter 0.44 mi ~9 min
11701 Metcalf Avenue, Overland Park 66210
Mo-Su 06:00-23:00
EV charging ChargePoint 0.45 mi ~10 min
EV charging 0.46 mi ~10 min
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 04-25136 | KS | Specialist |
| 04-25136 | KS | Clinical Medical Laboratory |
This provider holds licence 04-25136 issued in KS. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 1153393194
Enrolled in Medicare 2 times, across 2 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Kansas | O20040810000666 | Part B Supplier - Clinic/group Practice |
| Missouri | O20220708001939 | Part B Supplier - Clinic/group Practice |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. There are 2 separate enrolment records across 2 states (KS, MO). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What MOHS-Micrographic Surgery covers
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. NUCC Health Care Provider Taxonomy, code 207ND0101X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 174400000X | Specialist | 04-25136 | KS | |
| 291U00000X | Clinical Medical Laboratory | 04-25136 | KS | |
| 207ND0101X | MOHS-Micrographic Surgery Physician MOHS-Micrographic Surgery | — | — | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1003016312 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jul 24, 2007 |
| Last updated | Jun 3, 2022 |
| Status | Active |
| Practice address |
6901 W 121ST ST Overland Park, KS 66209 (913) 661-1755 Fax (913) 661-9260 |
| Other names |
Advanced Dermatologic Surgery Former Legal Name Trinity Dermatology Former Legal Name |
| Other identifiers |
17D0890923
· Other |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 0 | 1 | 6 | 3 | 1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 0 | 1 | 3 | 3 | 2 |
Sum = 38 · next multiple of 10 = 40 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.