SKIN SURGERY INSTITUTE (OF DFW)
NPI 1063988541
Dermatology - MOHS-Micrographic Surgery in Grapevine, TX

Q: What is Dermasurgery Specialist, PLLC's NPI number?

The NPI number for Dermasurgery Specialist, PLLC is 1063988541. It was assigned to this organization in the NPPES registry on October 23, 2018. The provider is doing business as Skin Surgery Institute (of Dfw).

Q: What is Dermasurgery Specialist, PLLC's specialty?

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

Active since October 23, 2018CLIA 45D2159884 · Certificate of Compliance

2020 W STATE HIGHWAY 114 STE 340, GRAPEVINE, TX 76051(817) 464-5000 Get Directions Write a Review

NPPES record last updated: November 4, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 4, 2018, Oct 28, 2018 (2 updates tracked since 2018).

On this page

About Skin Surgery Institute (of Dfw) NPPES

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

SKIN SURGERY INSTITUTE (OF DFW) (NPI 1063988541) is a healthcare organization registered as a mohs-micrographic surgery in Grapevine, Texas and active in the NPI registry since October 2018. The organization holds a CLIA Certificate of Compliance certificate valid through April 29, 2027 and lists Saira B Momin, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1063988541

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameDERMASURGERY SPECIALIST, PLLC

Location Address2020 W STATE HIGHWAY 114 STE 340Grapevine, TX 76051-8650

Mailing Address2728 Mckinnon St Apt 610Dallas, TX 75201-1636 · (281) 744-6708

Phone(817) 464-5000

Organization SubpartNo

Authorized OfficialSaira B MominOwner/president · (817) 464-5000

Enumeration DateOctober 23, 2018

Last NPPES UpdateNovember 4, 20182 updates tracked since enumeration

✔ NPI 1063988541 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.

2020 W STATE HIGHWAY 114 STE 340, Grapevine, TX 76051

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Other Names 1

Doing Business AsSkin Surgery Institute (of Dfw)

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Skin Surgery Institute (of Dfw) 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 Skin Surgery Institute (of Dfw), which bills Medicare for the services this clinician delivers.

Clinician (1)

Saira Momin, DO

Micrographic Dermatologic Surgery (MDS)

NPI 1841458619

2020 W STATE HIGHWAY 114 STE 340
Grapevine, TX 76051

(817) 410-7700

✔ 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 45D2159884

Dermasurgery Specialist, PLLC · Grapevine, TX

Active · expires Apr 29, 2027

CLIA Number45D2159884

Laboratory TypePhysician Office

Certificate Effective DateApril 30, 2025

Certificate Expiration DateApril 29, 2027

Laboratory DirectorSaira B. Momin

Laboratory Phone(817) 410-7700

Laboratory LocationDermasurgery Specialist, PLLC2020 West State Highway 114 Suite 340, Grapevine, TX 76051

CLIA data matches this NPI record on: Address 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 Dermasurgery Specialist, PLLC's NPI number?

The NPI number for Dermasurgery Specialist, PLLC is 1063988541. It was assigned to this organization in the NPPES registry on October 23, 2018. The provider is doing business as Skin Surgery Institute (of Dfw).

Where is Dermasurgery Specialist, PLLC located?

Dermasurgery Specialist, PLLC is located at 2020 W State Highway 114 Ste 340, Grapevine, TX 76051. The listed phone number is (817) 464-5000.

What is Dermasurgery Specialist, PLLC's specialty?

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

Is Dermasurgery Specialist, PLLC enrolled in Medicare?

Yes. Dermasurgery Specialist, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermasurgery Specialist, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Micrographic Dermatologic Surgery (MDS)) reassigns their Medicare billing to Dermasurgery Specialist, 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 Dermasurgery Specialist, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D2159884) is associated with this NPI, valid through April 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermasurgery Specialist, PLLC was last updated on November 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.