PREMIER PROCEDURAL DERMATOLOGY PLLC
NPI 1053969287
Dermatology - MOHS-Micrographic Surgery in College Station, TX

Q: What is Premier Procedural Dermatology PLLC's NPI number?

The NPI number for Premier Procedural Dermatology PLLC is 1053969287. It was assigned to this organization in the NPPES registry on August 30, 2019.

Q: What is Premier Procedural Dermatology PLLC's specialty?

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

Active since August 30, 2019CLIA 45D2172119 · Certificate of Compliance

1651 ROCK PRAIRIE RD STE 103, COLLEGE STATION, TX 77845(979) 314-5400(979) 704-5603 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 3, 2020, Aug 30, 2019 (2 updates tracked since 2019).

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About Premier Procedural Dermatology Pllc NPPES

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

PREMIER PROCEDURAL DERMATOLOGY PLLC (NPI 1053969287) is a healthcare organization registered as a mohs-micrographic surgery in College Station, Texas and active in the NPI registry since August 2019. The organization holds a CLIA Certificate of Compliance certificate valid through May 18, 2027 and lists Ryan William Ahern, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1053969287

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NamePREMIER PROCEDURAL DERMATOLOGY PLLC

Location Address1651 ROCK PRAIRIE RD STE 103College Station, TX 77845-8652

Mailing Address1651 Rock Prairie Rd Ste 103College Station, TX 77845-8652 · (979) 314-5400 · Fax (979) 704-5603

Phone(979) 314-5400

Fax(979) 704-5603

Organization SubpartNo

Authorized OfficialRyan William AhernProvider/owner · (979) 314-5400

Enumeration DateAugust 30, 2019

Last NPPES UpdateApril 3, 20202 updates tracked since enumeration

NPPES CertifiedApril 3, 2020

✔ NPI 1053969287 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.

1651 ROCK PRAIRIE RD STE 103, College Station, TX 77845

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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)

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

Clinician (1)

Ryan Ahern, MD

Dermatology

NPI 1003033838

1651 ROCK PRAIRIE RD STE 103
College Station, TX 77845

(979) 314-5400

✔ 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 Compliance 45D2172119

Premier Procedural Dermatology PLLC · College Station, TX

Active · expires May 18, 2027

CLIA Number45D2172119

Laboratory TypePhysician Office

Certificate Effective DateMay 19, 2025

Certificate Expiration DateMay 18, 2027

Laboratory DirectorRyan W. Ahern

Laboratory Phone(979) 314-5400

Laboratory LocationPremier Procedural Dermatology PLLC1651 Rock Prairie Rd, Suite 103, College Station, TX 77845

CLIA data matches this NPI record on: Address Name Phone

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 Premier Procedural Dermatology PLLC's NPI number?

The NPI number for Premier Procedural Dermatology PLLC is 1053969287. It was assigned to this organization in the NPPES registry on August 30, 2019.

Where is Premier Procedural Dermatology PLLC located?

Premier Procedural Dermatology PLLC is located at 1651 Rock Prairie Rd Ste 103, College Station, TX 77845. The listed phone number is (979) 314-5400.

What is Premier Procedural Dermatology PLLC's specialty?

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

Is Premier Procedural Dermatology PLLC enrolled in Medicare?

Yes. Premier Procedural Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premier Procedural Dermatology PLLC?

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

Yes. A Certificate of Compliance (number 45D2172119) is associated with this NPI, valid through May 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Premier Procedural Dermatology PLLC accept?

Health plans from Blue Cross and Blue Shield of Texas list Premier Procedural Dermatology PLLC 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 Premier Procedural Dermatology PLLC was last updated on April 3, 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.