Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kishore Linga Jayakumar

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104321942

Kishore Linga Jayakumar is a Dermatology in Upland, Pennsylvania. Qualified in 2018, 8 years ago. Practices with Clinical Dermatology Center LLC, a 7-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
8
Licensed in
VA
In the registry since
2018
Specialties on file
2
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Practice location Partly verified

Some contact details are missing from the federal record.

One Medical Center Blvd Dept OF Medicine - Third Fl East Wing
Upland, PA 19013
Phone: (610) 447-6370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 0101275802 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104321942
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 26, 2018
Last updated in NPPESNovember 30, 2022
Certification dateNovember 30, 2022
Mailing addressOne Medical Center Boulevard, Department Of Medicine - Third Floor, East Wing, Upland, PA 19013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Clinical Dermatology Center Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Upland