Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1417955584 Individual Practitioner Male Practitioner

Dr. Edward B Lack , MD

Dermatology • Brandon, FL

Professional Overview & Biography Verified Profile Summary

Dr. Edward Lack, MD is a registered healthcare professional specializing in Dermatology in Brandon, FL. Practice services are available at 540 MEDICAL OAKS AVE under active NPI credentials.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

540 Medical Oaks Ave
Suite 102

Brandon, FL 335115995

Telephone 8136511991
Fax 8136511401
Associated Practice Facility / Clinic
🏢 Brandon Eye Associates Pa Facility NPI 1215969357

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Brandon, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.0 Yrs
State Avg: 23.7 Yrs
Regional Practice Density
20 Specialists

Practicing in Brandon, FL (1273 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
45.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths
190 38 $19.00 $5.28
99213 Established patient office or other outpatient visit, typically 15 minutes
177 117 $117.00 $71.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
86 80 $178.00 $103.97
17000 Destruction of skin growth
68 59 $135.00 $53.11
11100 Biopsy of single growth of skin and/or tissue
61 56 $177.00 $99.06
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
43 43 $183.00 $102.76
99202 New patient office or other outpatient visit, typically 20 minutes
40 40 $125.00 $72.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
33 25 $73.00 $43.34
17110 Destruction of up to 14 skin growths
19 17 $191.00 $102.10

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License IL 036-043409

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License FL ME114654

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bcbs
0021603804

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Tony Nelson , PA-C, MPAS

Physician Assistant - Medical

NPI 1083662159

Physician Assistant (Certified), MPAS

Omar Daabies , PA

Physician Assistant

NPI 1578179479

Physician Assistant

Anisha Bhanot

Dermatology

NPI 1629665914
NPI 1902366008

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 15, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 15, 2016

Registered at 540 MEDICAL OAKS AVE, SUITE 102, BRANDON, FL 335115995 (Tel: 8136511991)

📍
Updated Business Mailing Address November 15, 2016

Registered at 151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 327517176 (Tel: 4078752080)

👤
Provider Name / Credentials Updated November 15, 2016

Recorded as EDWARD LACK, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2016

Dermatology (License #036-043409 in IL)

🟢
Initial NPI Registration & Enumeration July 12, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417955584
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 12, 2005
Last Update: November 15, 2016
Sole Proprietor: No

Mailing Address

151 Southhall Ln, Suite 300

Maitland, FL 327517176

Phone: 4078752080

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.