ESSEX DERMATOLOGY LLC
NPI 1043378508
Dermatology in Essex, CT
About Essex Dermatology Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ESSEX DERMATOLOGY LLC (NPI 1043378508) is a healthcare organization registered as a dermatology in Essex, Connecticut and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through December 9, 2027 and lists Virginia L Maher Wiese, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Essex Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Essex Dermatology LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 07D2245257
Essex Dermatology LLC · Essex, 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 Essex Dermatology LLC's NPI number?
The NPI number for Essex Dermatology LLC is 1043378508. It was assigned to this organization in the NPPES registry on December 5, 2006.
Where is Essex Dermatology LLC located?
Essex Dermatology LLC is located at 20 Saybrook Road, Essex, CT 06426. The listed phone number is (860) 767-9998.
What is Essex Dermatology LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Essex Dermatology LLC enrolled in Medicare?
Yes. Essex Dermatology LLC is registered in the Medicare PECOS enrollment system.
When is Essex Dermatology LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Connecticut, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Essex Dermatology LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Essex 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. The largest specialties are Nurse Practitioner (3), Dermatology (1) and Internal Medicine (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Essex Dermatology LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 07D2245257) is associated with this NPI, valid through December 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Essex Dermatology LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Essex 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 Essex Dermatology LLC was last updated on November 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Essex Dermatology Llc · NPI 1043378508
Dermatology organization in Essex, Connecticut. Organization record, active in the CMS NPPES registry since December 5, 2006.
## Identity
- **NPI:** 1043378508 (Entity type: Organization)
- **Enumerated:** December 5, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Virginia Maher Wiese, OWNER
## Practice location
- **Address:** 20 SAYBROOK ROAD, Essex, CT 06426-1401
- **Phone:** (860) 767-9998 · **Fax:** (860) 767-9161
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Connecticut, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Dermatology (1), Internal Medicine (1); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 15, 2012
- **Other identifiers:** Other C03091 (CT)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1043378508) · Data from the CMS NPPES public registry.