ELITE DERMATOLOGY PHYSICIANS PLLC
NPI 1003644402
Dermatology in New Canaan, CT
About Elite Dermatology Physicians Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELITE DERMATOLOGY PHYSICIANS PLLC (NPI 1003644402) is a healthcare organization registered as a dermatology in New Canaan, Connecticut and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through January 29, 2027 and lists Ellen De Moll, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elite Dermatology Physicians Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Elite Dermatology Physicians PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 07D2317708
Elite Dermatology Physicians · New Canaan, CTFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Elite Dermatology Physicians PLLC's NPI number?
The NPI number for Elite Dermatology Physicians PLLC is 1003644402. It was assigned to this organization in the NPPES registry on July 25, 2024.
Where is Elite Dermatology Physicians PLLC located?
Elite Dermatology Physicians PLLC is located at 38 East Ave, New Canaan, CT 06840. The listed phone number is (415) 802-1310.
What is Elite Dermatology Physicians PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Elite Dermatology Physicians PLLC enrolled in Medicare?
Yes. Elite Dermatology Physicians PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Elite Dermatology Physicians PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Elite Dermatology Physicians PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Elite Dermatology Physicians PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 07D2317708) is associated with this NPI, valid through January 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Elite Dermatology Physicians PLLC was last updated on July 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.