Active NPI 1710325758 Individual Practitioner Male Practitioner

Dr. Benjamin Merrill Perry , DO

Dermatology • Meridian, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Perry, DO is a certified Dermatology practicing in Meridian, ID. With approximately 13 years of clinical experience since completing medical education in 2013, Dr. Perry delivers high-quality medical care to the local community at 4664 N PENNGROVE WAY STE 100.

Dr. Perry is affiliated with Mountain Pine Dermatology Pllc and accepts Medicare assignment.

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

4664 N Penngrove Way Ste 100

Meridian, ID 836467442

Telephone 2088987467

Fax 2083982120

Associated Practice Facility / Clinic

🏢 Mountain Pine Dermatology, Pllc Facility NPI 1659827665

Medicare Profile & Education

Medical School

Other

Graduation Year

2013

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Meridian, ID

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

13 Yrs -1.1 yrs vs City Avg

City Avg: 14.1 Yrs

State Avg: 23.0 Yrs

Regional Practice Density

13 Specialists

Practicing in Meridian, ID (63 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

64.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Perry (13 Years) 13 Yrs

Meridian Specialty Average (14.1 Years) 14.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,294	230	$13.32	$6.14
99213 Established patient office or other outpatient visit, typically 15 minutes	604	433	$175.00	$84.22
17000 Destruction of skin growth	361	280	$138.00	$50.56
11102 Tangential biopsy of single skin lesion	156	136	$200.00	$81.94
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	143	108	$1367.00	$556.01
17110 Destruction of up to 14 skin growths	90	83	$229.00	$101.62
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	84	48	$803.00	$373.04
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	72	64	$626.00	$223.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	68	68	$222.00	$102.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	54	$250.00	$118.75
11103 Biopsy of related skin growth, each additional growth	57	34	$108.00	$45.85
17004 Destruction of precancer skin growth, 15 or more growths	47	42	$310.00	$153.98
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	37	33	$125.00	$52.36
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	37	13	$15.00	$1.03
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	36	32	$513.00	$111.36
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	28	23	$1278.00	$547.53
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	28	28	$608.00	$163.45
11104 Punch biopsy, first skin growth	22	21	$250.00	$114.03
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	19	16	$883.00	$191.68
69100 Biopsy of ear	17	11	$208.00	$56.70
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	15	$586.00	$127.49
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	15	13	$986.00	$213.15
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	14	11	$770.00	$356.49
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	11	$342.00	$77.66
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$315.00	$153.96
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	11	11	$590.64	$152.89
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	11	11	$534.00	$175.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,221	235	$12.00	$6.20
99213 Established patient office or other outpatient visit, typically 15 minutes	668	455	$175.00	$83.57
17000 Destruction of skin growth	374	296	$138.00	$49.46
11102 Tangential biopsy of single skin lesion	178	161	$200.00	$84.21
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	160	123	$1367.00	$542.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	152	152	$222.00	$102.37
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	115	17	$15.00	$1.06
17110 Destruction of up to 14 skin growths	99	91	$229.00	$99.73
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	90	56	$803.00	$373.92
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	64	58	$626.00	$230.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	50	$250.00	$119.10
11103 Biopsy of related skin growth, each additional growth	56	35	$108.00	$45.70
17004 Destruction of precancer skin growth, 15 or more growths	42	34	$310.00	$156.52
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	36	34	$608.00	$160.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	32	29	$125.00	$51.32
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	27	26	$513.00	$124.30
11104 Punch biopsy, first skin growth	25	24	$250.00	$114.90
69100 Biopsy of ear	24	21	$208.00	$68.01
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	23	17	$50.00	$13.04
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	20	18	$1278.00	$550.24
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	19	19	$534.00	$142.65
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	16	$586.00	$127.90
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	13	13	$591.62	$175.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$315.00	$152.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,221	214	$12.01	$6.27
99213 Established patient office or other outpatient visit, typically 15 minutes	635	406	$159.16	$84.74
17000 Destruction of skin growth	380	287	$138.16	$49.55
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	210	163	$1495.02	$571.24
11102 Tangential biopsy of single skin lesion	191	166	$200.00	$89.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	172	172	$222.37	$104.01
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	136	84	$868.00	$383.55
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	107	21	$15.01	$1.14
17110 Destruction of up to 14 skin growths	84	74	$229.00	$104.40
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	64	61	$667.08	$226.38
11103 Biopsy of related skin growth, each additional growth	61	42	$108.00	$47.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	41	$236.24	$120.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	48	42	$101.35	$52.68
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	42	40	$666.33	$157.72
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	40	19	$50.00	$13.44
17004 Destruction of precancer skin growth, 15 or more growths	40	32	$310.00	$157.06
99202 New patient office or other outpatient visit, typically 20 minutes	28	28	$153.14	$67.83
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	24	22	$1420.46	$544.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$329.78	$156.03
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	20	$518.51	$113.45
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	20	19	$553.61	$158.83
69100 Biopsy of ear	20	18	$208.00	$69.79
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	15	15	$959.99	$219.76
11104 Punch biopsy, first skin growth	13	13	$250.00	$111.83
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$586.00	$129.49
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	12	11	$791.70	$188.38
11900 Injection into skin growth, 1-7 growths	11	11	$140.36	$43.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	736	144	$12.04	$6.10
99213 Established patient office or other outpatient visit, typically 15 minutes	435	301	$152.98	$86.32
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	314	242	$1593.67	$575.47
17000 Destruction of skin growth	252	203	$138.53	$51.30
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	159	111	$927.92	$399.62
11102 Tangential biopsy of single skin lesion	132	121	$201.38	$89.80
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	121	121	$222.00	$105.11
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	95	77	$90.84	$52.62
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	67	64	$699.01	$215.81
99202 New patient office or other outpatient visit, typically 20 minutes	66	66	$154.00	$68.29
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	56	15	$15.00	$1.32
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	54	53	$704.33	$160.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	40	$221.00	$122.67
17110 Destruction of up to 14 skin growths	50	46	$231.25	$102.51
11103 Biopsy of related skin growth, each additional growth	43	33	$108.00	$49.17
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	38	34	$1500.05	$554.50
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	33	13	$50.00	$13.25
17004 Destruction of precancer skin growth, 15 or more growths	26	24	$310.00	$154.28
11104 Punch biopsy, first skin growth	23	23	$250.00	$120.61
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	22	22	$751.93	$170.12
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	19	$552.08	$119.54
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	18	18	$888.95	$177.08
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	14	14	$613.41	$157.54
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	13	13	$1233.70	$253.75
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	13	13	$1203.55	$242.32
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	12	12	$748.87	$205.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$335.00	$158.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	694	114	$12.23	$5.70
99213 Established patient office or other outpatient visit, typically 15 minutes	331	220	$151.06	$70.97
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	200	160	$1542.56	$506.66
17000 Destruction of skin growth	195	165	$139.08	$50.21
99202 New patient office or other outpatient visit, typically 20 minutes	171	171	$154.00	$70.88
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	135	79	$889.76	$387.50
11102 Tangential biopsy of single skin lesion	130	126	$202.31	$83.25
11103 Biopsy of related skin growth, each additional growth	61	39	$108.89	$50.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	59	51	$96.78	$43.60
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	57	55	$686.96	$226.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	52	52	$222.00	$101.71
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	47	12	$15.04	$1.41
17110 Destruction of up to 14 skin growths	44	42	$230.16	$103.39
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	29	29	$1456.14	$585.12
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	29	28	$704.31	$156.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	24	$221.00	$102.85
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	24	23	$564.33	$120.16
69100 Biopsy of ear	21	15	$214.00	$60.42
17004 Destruction of precancer skin growth, 15 or more growths	19	18	$310.00	$142.75
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	17	17	$2191.12	$873.67
11900 Injection into skin growth, 1-7 growths	14	11	$140.00	$44.84
11104 Punch biopsy, first skin growth	14	13	$267.14	$103.07
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	11	$650.50	$149.38
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	11	11	$819.27	$176.69
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	11	11	$1790.00	$720.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	610	107	$12.47	$5.29
99213 Established patient office or other outpatient visit, typically 15 minutes	292	204	$153.36	$71.10
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	261	223	$1606.56	$555.82
99202 New patient office or other outpatient visit, typically 20 minutes	191	191	$154.57	$72.32
17000 Destruction of skin growth	179	149	$140.35	$48.22
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	155	114	$935.54	$393.17
11102 Tangential biopsy of single skin lesion	137	129	$205.47	$86.22
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	85	85	$222.56	$102.12
11103 Biopsy of related skin growth, each additional growth	64	44	$110.11	$50.41
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	61	57	$1251.57	$244.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	60	53	$94.58	$42.71
17110 Destruction of up to 14 skin growths	47	45	$233.34	$100.30
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	41	41	$700.59	$228.81
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	31	27	$1509.45	$557.18
17004 Destruction of precancer skin growth, 15 or more growths	30	27	$312.67	$143.79
11104 Punch biopsy, first skin growth	18	18	$253.33	$118.95
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	15	15	$706.00	$158.29
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$685.80	$165.33
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	14	14	$1805.57	$736.87
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	14	$650.50	$198.66
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	12	12	$1800.00	$726.04
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$559.67	$183.56
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	11	11	$2535.00	$946.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	291	47	$17.22	$5.10
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	284	241	$1470.82	$553.42
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	118	90	$870.12	$383.55
99213 Established patient office or other outpatient visit, typically 15 minutes	99	92	$179.34	$70.88
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	71	62	$1342.17	$550.60
11100 Biopsy of single growth of skin and/or tissue	70	68	$241.77	$86.52
17000 Destruction of skin growth	64	63	$170.81	$50.65
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	55	55	$666.80	$166.64
99202 New patient office or other outpatient visit, typically 20 minutes	50	50	$161.80	$71.23
11101 Biopsy of each additional growth of skin and/or tissue	45	26	$73.29	$32.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	43	$258.14	$106.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$239.46	$102.98
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	31	31	$1289.10	$238.15
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	28	28	$1734.29	$735.94
17110 Destruction of up to 14 skin growths	24	24	$259.75	$105.02
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	23	22	$642.91	$151.16
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	23	23	$595.00	$147.13
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	22	22	$1775.00	$764.17
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	21	21	$673.14	$145.39
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	15	15	$546.00	$126.81
17004 Destruction of precancer skin growth, 15 or more growths	14	14	$384.29	$143.90
13151 Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm	12	12	$874.83	$210.89
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	11	11	$1000.00	$213.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$104.55	$43.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	131	24	$20.00	$6.80
99213 Established patient office or other outpatient visit, typically 15 minutes	39	38	$184.49	$87.83
17000 Destruction of skin growth	36	36	$180.00	$60.91
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	32	30	$1475.00	$674.35
11100 Biopsy of single growth of skin and/or tissue	23	23	$249.13	$108.97
99202 New patient office or other outpatient visit, typically 20 minutes	23	23	$180.00	$92.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$260.00	$128.44
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	17	12	$875.00	$477.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	14	$260.00	$123.69
17110 Destruction of up to 14 skin growths	13	13	$267.69	$128.66

Medical Specialties & State Licenses

CMS Verified: 2020-10-01

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License ID O1145

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 OR DO168846

Dermatology - MOHS-Micrographic Surgery

NUCC Taxonomy Code: 207ND0101X

State License ID O1145

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.

General Practice

NUCC Taxonomy Code: 208D00000X

State License OR PG163364

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Hospital & Practice Group Affiliations

Mountain Pine Dermatology Pllc

1202 E Locust St, Emmett, ID 836172715

Phone: 2088987467

Mountain Pine Dermatology Pllc

4664 N Penngrove Way, Meridian, ID 836467442

Phone: 2088987467

Mountain Pine Dermatology Pllc

3175 Pocahontas Rd, Baker City, OR 978141434

Phone: 2088987467

Mountain Pine Dermatology Pllc

110 Rattlesnake Ave, Mountain Home, ID 836474219

Phone: 2088987467

Secondary Practice Locations

1793 13th St Se

Salem, OR 97302

Phone: 5033628385

Practice Associates & Co-Workers

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

5 Associated Practitioners

Ladessa Christensen , NP-C

Nurse Practitioner - Family

NPI 1215367685

Nurse Practitioner (Certified)

Dr. Richard Thomas , DO

Dermatology

NPI 1265795660

Doctor of Osteopathic Medicine (D.O.)

Jennifer Wicklund , FNP-C

Nurse Practitioner - Family

NPI 1871165118

Family Nurse Practitioner (Certified)

Dr. Vienna Katana , DO

Dermatology

NPI 1871832881

Doctor of Osteopathic Medicine (D.O.)

Dr. Avery Dinallo , DNP, APN, FNP-C

Nurse Practitioner - Family

NPI 1902328404

Doctor of Nursing Practice, Advanced Practice Nurse, Family Nurse Practitioner (Certified)

Career & Practice History Timeline

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

15 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2020

Dermatology (License #DO168846 in OR)

📍

Updated Practice Location July 05, 2020

Registered at 4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 836467442 (Tel: 2088987467)

📍

Updated Business Mailing Address July 05, 2020

Registered at 4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 836467442 (Tel: 2088987467)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 05, 2020

General Practice (License #PG163364 in OR)

📍

Updated Practice Location November 27, 2019

Registered at 1576 W DEER CREST DR STE 100, MERIDIAN, ID 836464643 (Tel: 0000000000)

📍

Updated Business Mailing Address November 27, 2019

Registered at 1576 W DEER CREST DR # 100, MERIDIAN, ID 836464643 (Tel: 2088987467)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 27, 2019

Dermatology (License #DO168846 in OR)

📍

Updated Practice Location September 04, 2018

Registered at 1793 13TH ST SE, SALEM, OR 97302 (Tel: 5033628385)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2018

General Practice (License #PG163364 in OR)

✅

NPI Profile Active July 17, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location July 17, 2015

Registered at 1793 13TH ST SE, SALEM, OR 973022541 (Tel: 5033628385)

📍

Updated Business Mailing Address July 17, 2015

Registered at 1793 13TH ST SE, SALEM, OR 973022541 (Tel: 5033628385)

👤

Provider Name / Credentials Updated July 17, 2015

Recorded as BENJAMIN PERRY, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2015

Dermatology (License #DO168846 in OR)

🟢

Initial NPI Registration & Enumeration June 12, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1710325758

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 12, 2013

Last Update: October 01, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

4664 N Penngrove Way Ste 100

Meridian, ID 836467442

Phone: 2088987467

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.