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DYNAMIC DERMATOLOGY, PLLC
NPI 1043876568
Clinic/Center - Medical Specialty in San Antonio, TX

Active since May 10, 2019CLIA 45D2190404 · Waiver
13535 HAUSMAN PASS STE 104, SAN ANTONIO, TX 78249(210) 951-5530(210) 951-9080 Get Directions Write a Review

NPPES record last updated: August 6, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 6, 2020, May 10, 2019 (2 updates tracked since 2019).

About Dynamic Dermatology, Pllc NPPES

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

DYNAMIC DERMATOLOGY, PLLC (NPI 1043876568) is a healthcare organization registered as a medical specialty in San Antonio, Texas and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through August 12, 2028 and lists Sarah Groff, President, as its authorized official.

NPPES Registry Identity

NPI1043876568
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameDYNAMIC DERMATOLOGY, PLLC
Location Address13535 HAUSMAN PASS STE 104San Antonio, TX 78249-3581
Mailing Address13535 Hausman Pass Ste 104San Antonio, TX 78249-3581
Phone(210) 951-5530
Fax(210) 951-9080
Organization SubpartNo
Authorized OfficialSarah GroffPresident · (210) 951-5530
Enumeration DateMay 10, 2019
Last NPPES UpdateAugust 6, 20202 updates tracked since enumeration
NPPES CertifiedAugust 6, 2020
✔ NPI 1043876568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
13535 HAUSMAN PASS STE 104, San Antonio, TX 78249
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dynamic Dermatology, 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 Dynamic Dermatology, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sarah Groff, MD
Dermatology
NPI 1497192082
13535 HAUSMAN PASS STE 104
San Antonio, TX 78249
(210) 951-5530
✔ PECOS✔ Accepts MedicareSame address

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 45D2190404

Dynamic Dermatology · San Antonio, TX
Active · expires Aug 12, 2028
CLIA Number45D2190404
Laboratory TypePhysician Office
Certificate Effective DateAugust 13, 2026
Certificate Expiration DateAugust 12, 2028
Laboratory DirectorSarah E Groff
Laboratory Phone(210) 951-5530
Laboratory LocationDynamic Dermatology13535 Hausman Pass, Ste 104, San Antonio, TX 78249
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Dynamic Dermatology, PLLC's NPI number?

The NPI number for Dynamic Dermatology, PLLC is 1043876568. It was assigned to this organization in the NPPES registry on May 10, 2019.

Where is Dynamic Dermatology, PLLC located?

Dynamic Dermatology, PLLC is located at 13535 Hausman Pass Ste 104, San Antonio, TX 78249. The listed phone number is (210) 951-5530.

What is Dynamic Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Dynamic Dermatology, PLLC enrolled in Medicare?

Yes. Dynamic Dermatology, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dynamic Dermatology, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Dynamic Dermatology, 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 Dynamic Dermatology, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2190404) is associated with this NPI, valid through August 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dynamic Dermatology, PLLC was last updated on August 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.