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ADVANCED DERMATOLOGY AND COSMETIC SURQ
NPI 1083872535
Dermatology in Sebastian, FL

Active since May 30, 2008CLIA 10D2096188 · Accreditation
484 US HIGHWAY 1, STE C, SEBASTIAN, FL 32958(772) 646-6100(772) 646-6110 Get Directions Write a Review

NPPES record last updated: May 10, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Advanced Dermatology And Cosmetic Surq NPPES

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

ADVANCED DERMATOLOGY AND COSMETIC SURQ (NPI 1083872535) is a healthcare organization registered as a dermatology in Sebastian, Florida and active in the NPI registry since May 2008. The organization holds an CLIA Accreditation certificate valid through February 26, 2028 and lists Amy Declue, Director Of Provider Services, as its authorized official.

NPPES Registry Identity

NPI1083872535
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address484 US HIGHWAY 1, STE CSebastian, FL 32958-8497
Mailing Address151 Southhall Ln, Ste 300Maitland, FL 32751-7176 · (407) 875-2080 · Fax (407) 650-3455
Phone(772) 646-6100
Fax(772) 646-6110
Organization SubpartYes
Authorized OfficialAmy DeclueDirector Of Provider Services · (407) 875-2080
Enumeration DateMay 30, 2008
Last NPPES UpdateMay 10, 2017
✔ NPI 1083872535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPlastic SurgeryTaxonomy 208200000X
484 US HIGHWAY 1, Sebastian, FL 32958
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Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Surq

Other Identifiers 1

Medicare PIN98046BFL

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 Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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)

Advanced Dermatology And Cosmetic Surq is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

115

Medicare enrollment records show 115 clinicians reassign Medicare billing to Advanced Dermatology And Cosmetic Surq, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Dermatology63
Nurse Practitioner35
Plastic and Reconstructive Surgery8
Pathology5
Micrographic Dermatologic Surgery (MDS)2
Otolaryngology1
Physician Assistant1

Nearest to this location (20)

See all 115
Evdakiya Deiner, APRN
Nurse Practitioner
NPI 1457755795
484 US HIGHWAY 1 STE C
Sebastian, FL 32958
(772) 646-6100
✔ PECOS✔ Accepts Medicare1.2 mi
Angela Wipf, MD
Dermatology
NPI 1831752211
3755 7TH TER STE 101
Vero Beach, FL 32960
(772) 569-5056
✔ PECOS✔ Accepts Medicare11 mi
Mary Collins
Nurse Practitioner
NPI 1588537583
3755 7TH TER STE 101
Vero Beach, FL 32960
(772) 569-5056
✔ PECOS✔ Accepts Medicare11 mi
Patrick Ottuso, M D F A A D
Dermatology
NPI 1386627867
1955 22ND AVE
Vero Beach, FL 32960
(772) 299-0085
✔ PECOS12 mi
Alexandra Grammenos, DO
Dermatology
NPI 1477059590
2305 VIDINA DR STE 102
Melbourne, FL 32940
(321) 441-8332
✔ PECOS✔ Accepts Medicare33 mi
Sean Singh, MD
Dermatology
NPI 1104359363
1555 NW SAINT LUCIE WEST BLVD STE 101
Port St Lucie, FL 34986
(772) 318-4945
✔ PECOS✔ Accepts Medicare34 mi
Savina Aneja
Dermatology
NPI 1184985996
9368 NARCOOSSEE RD STE 104
Orlando, FL 32827
(407) 745-1966
✔ PECOS✔ Accepts Medicare65 mi
Valenie Rivera Roig, M.D.
Dermatology
NPI 1295784957
14050 TOWN LOOP BLVD SUITE 203
Orlando, FL 32837
(407) 852-6650
✔ PECOS✔ Accepts Medicare70 mi
Raymond Ramirez, DO
Dermatology
NPI 1063614840
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts Medicare71 mi
Adrianna Mills
Nurse Practitioner
NPI 1962022798
2915 LAKEVIEW DR STE 2021
Fern Park, FL 32730
(866) 400-3376
✔ PECOS✔ Accepts Medicare79 mi
Dilan Ipek
Nurse Practitioner
NPI 1952188633
4970 S US HIGHWAY 17/92
Casselberry, FL 32707
(407) 635-8012
✔ PECOS✔ Accepts Medicare80 mi
Shreyal Patel
Nurse Practitioner
NPI 1992381198
151 SOUTHHALL LN STE 300
Maitland, FL 32751
(407) 875-2080
✔ PECOS✔ Accepts Medicare80 mi
Julie Goldstein
Nurse Practitioner
NPI 1275176042
15222 BOOK CLUB RD
Winter Garden, FL 34787
(954) 214-1167
✔ PECOS✔ Accepts Medicare83 mi
Nicole Cabbad, M.D., M.B.A.
Plastic and Reconstructive Surgery
NPI 1306133004
120 INTERNATIONAL PKWY
Lake Mary, FL 32746
(866) 400-3376
✔ PECOS✔ Accepts Medicare86 mi
Lauren Leavitt, PA
Physician Assistant
NPI 1457789307
120 INTERNATIONAL PARKWAY SUITE 300
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare86 mi
Michael Burton, M.D.
Plastic and Reconstructive Surgery
NPI 1184850018
120 INTERNATIONAL PKWY SUITE 240
Heathrow, FL 32746
(407) 333-4200
✔ PECOS✔ Accepts Medicare86 mi
Kenneth Phillips, MD
Plastic and Reconstructive Surgery
NPI 1306924022
202 LAKE MIRIAM DR UNIT 1
Lakeland, FL 33813
(866) 400-3376
✔ PECOS✔ Accepts Medicare92 mi
Robin Burger
Pathology
NPI 1588058648
1300 NW 17TH AVE STE 130
Delray Beach, FL 33445
(561) 819-0857
✔ PECOS✔ Accepts Medicare94 mi
Shuo Liu, MD; PHD
Pathology
NPI 1336644590
1300 NW 17TH AVE
Delray Beach, FL 33445
(773) 816-4522
✔ PECOS✔ Accepts Medicare94 mi
Etan Marks, D.O.
Pathology
NPI 1528301728
1300 NW 17TH AVE STE 130A
Delray Beach, FL 33445
(866) 400-3376
✔ PECOS✔ Accepts Medicare94 mi
See all 115 clinicians

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 Accreditation 10D2096188

Advanced Dermatology And Cosmetic Surgery · Sebastian, FL
Active · expires Feb 26, 2028
CLIA Number10D2096188
Laboratory TypePhysician Office
Certificate Effective DateFebruary 27, 2026
Certificate Expiration DateFebruary 26, 2028
Laboratory DirectorScott Podnos
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery484 Us Hwy 1 Ste C, Sebastian, FL 32958
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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 Leavitt Medical Associates Of Florida Inc's NPI number?

The NPI number for Leavitt Medical Associates Of Florida Inc is 1083872535. It was assigned to this organization in the NPPES registry on May 30, 2008. The provider is doing business as Advanced Dermatology And Cosmetic Surq.

Where is Leavitt Medical Associates Of Florida Inc located?

Leavitt Medical Associates Of Florida Inc is located at 484 Us Highway 1 Ste C, Sebastian, FL 32958. The listed phone number is (772) 646-6100.

What is Leavitt Medical Associates Of Florida Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Leavitt Medical Associates Of Florida Inc enrolled in Medicare?

Yes. Leavitt Medical Associates Of Florida Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Leavitt Medical Associates Of Florida Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 115 clinicians in 7 Medicare specialties reassign their Medicare billing to Leavitt Medical Associates Of Florida Inc. 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 Dermatology (63), Nurse Practitioner (35) and Plastic and Reconstructive Surgery (8). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Leavitt Medical Associates Of Florida Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 10D2096188) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Leavitt Medical Associates Of Florida Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Leavitt Medical Associates Of Florida Inc 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 Leavitt Medical Associates Of Florida Inc was last updated on May 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.