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WALL DERMATOLOGY, LLC
NPI 1003668328
Dermatology - MOHS-Micrographic Surgery in St Petersburg, FL

Active since April 02, 2024CLIA 10D2315755 · Certificate of Compliance
1700 66TH ST N STE 300, ST PETERSBURG, FL 33710(727) 432-3225 Get Directions Write a Review

NPPES record last updated: August 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 5, 2024, Apr 2, 2024 (2 updates tracked since 2024).

About Wall Dermatology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALL DERMATOLOGY, LLC (NPI 1003668328) is a healthcare organization registered as a mohs-micrographic surgery in St Petersburg, Florida and active in the NPI registry since April 2024. The organization holds a CLIA Certificate of Compliance certificate valid through June 5, 2027 and lists Weston Wall, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1003668328
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameWALL DERMATOLOGY, LLC
Location Address1700 66TH ST N STE 300St Petersburg, FL 33710-5500
Mailing Address3000 Boca Ciega Dr NSaint Petersburg, FL 33710-2834 · (727) 432-3225
Phone(727) 432-3225
Organization SubpartNo
Authorized OfficialWeston WallPhysician Owner · (727) 432-3225
Enumeration DateApril 2, 2024
Last NPPES UpdateAugust 5, 20242 updates tracked since enumeration
NPPES CertifiedAugust 5, 2024
✔ NPI 1003668328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
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.
1700 66TH ST N STE 300, St Petersburg, FL 33710
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wall Dermatology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Wall Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Weston Wall, MD
Dermatology
NPI 1437512969
1700 66TH ST N STE 300
St Petersburg, FL 33710
(727) 606-9255
✔ PECOS✔ Accepts MedicareSame address
Brittany Abud, MD
Otolaryngology
NPI 1386104891
1740 W TAYLOR ST
Chicago, IL 60612
(866) 600-2273
✔ PECOS1,010 mi

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 Compliance 10D2315755

Wall Dermatology LLC · Saint Petersburg, FL
Active · expires Jun 5, 2027
CLIA Number10D2315755
Laboratory TypePhysician Office
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorWeston B. Wall
Laboratory Phone(727) 606-9255
Laboratory LocationWall Dermatology LLC1700 66th St N Ste 300, Saint Petersburg, FL 33710
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently 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 Wall Dermatology, LLC's NPI number?

The NPI number for Wall Dermatology, LLC is 1003668328. It was assigned to this organization in the NPPES registry on April 2, 2024.

Where is Wall Dermatology, LLC located?

Wall Dermatology, LLC is located at 1700 66th St N Ste 300, St Petersburg, FL 33710. The listed phone number is (727) 432-3225.

What is Wall Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Wall Dermatology, LLC enrolled in Medicare?

Yes. Wall Dermatology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wall Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Wall Dermatology, LLC, in Dermatology and Otolaryngology. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wall Dermatology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D2315755) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wall Dermatology, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Molina Healthcare list Wall Dermatology, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wall Dermatology, LLC was last updated on August 5, 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.