KAUAI DERMATOLOGY LLC
NPI 1033387980
Clinic/Center - Medical Specialty in Lihue, HI
About Kauai Dermatology Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAUAI DERMATOLOGY LLC (NPI 1033387980) is a healthcare organization registered as a medical specialty in Lihue, Hawaii and active in the NPI registry since February 2008. The organization lists Corina E Potter, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kauai Dermatology Llc 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 Kauai Dermatology LLC, 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.
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 Kauai Dermatology LLC's NPI number?
The NPI number for Kauai Dermatology LLC is 1033387980. It was assigned to this organization in the NPPES registry on February 13, 2008.
Where is Kauai Dermatology LLC located?
Kauai Dermatology LLC is located at 4366 Kukui Grove St Suite 201, Lihue, HI 96766. The listed phone number is (808) 246-6904.
What is Kauai Dermatology LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.
Is Kauai Dermatology LLC enrolled in Medicare?
Yes. Kauai Dermatology LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kauai Dermatology LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Kauai Dermatology LLC. 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.
When was this NPI record last updated?
The NPPES record for Kauai Dermatology LLC was last updated on May 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Kauai Dermatology Llc · NPI 1033387980
Medical Specialty organization in Lihue, Hawaii. Organization record, active in the CMS NPPES registry since February 13, 2008.
## Identity
- **NPI:** 1033387980 (Entity type: Organization)
- **Enumerated:** February 13, 2008
- **Primary specialty:** Clinic/Center - Medical Specialty · taxonomy 261QM2500X
- **Organization subpart:** No
- **Authorized official:** Corina Potter, OFFICE MANAGER
## Practice location
- **Address:** 4366 KUKUI GROVE ST, SUITE 201, Lihue, HI 96766-2006
- **Phone:** (808) 246-6904 · **Fax:** (808) 246-6081
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Dermatology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 29, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1033387980) · Data from the CMS NPPES public registry.