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SANCTUARY MEDICAL AESTHETIC CENTER OF BOCA RATON LLC
NPI 1104282714
Dermatology in Boca Raton, FL

Active since January 12, 2016CLIA 10D2141186 · Certificate of Compliance
4800 N FEDERAL HWY, SUITE C100, BOCA RATON, FL 33431(561) 886-0970 Get Directions Write a Review

NPPES record last updated: May 20, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 20, 2016, Jan 12, 2016 (2 updates tracked since 2016).

About Sanctuary Medical Aesthetic Center Of Boca Raton Llc NPPES

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

SANCTUARY MEDICAL AESTHETIC CENTER OF BOCA RATON LLC (NPI 1104282714) is a healthcare organization registered as a dermatology in Boca Raton, Florida and active in the NPI registry since January 2016. The organization holds a CLIA Certificate of Compliance certificate valid through January 15, 2028 and lists Jeff Davis, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104282714
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSANCTUARY MEDICAL AESTHETIC CENTER OF BOCA RATON LLC
Location Address4800 N FEDERAL HWY, SUITE C100Boca Raton, FL 33431-5188
Mailing Address4800 N Federal Hwy, Suite C100Boca Raton, FL 33431-5188 · (561) 886-0970
Phone(561) 886-0970
Organization SubpartNo
Authorized OfficialJeff DavisCeo · (561) 430-6644
Enumeration DateJanuary 12, 2016
Last NPPES UpdateMay 20, 20162 updates tracked since enumeration
✔ NPI 1104282714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
4800 N FEDERAL HWY, Boca Raton, FL 33431
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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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).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)

Sanctuary Medical Aesthetic Center Of Boca Raton Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Sanctuary Medical Aesthetic Center Of Boca Raton LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Allison Schwedelson, DO
Dermatology
NPI 1982822714
4800 N FEDERAL HWY STE 100C
Boca Raton, FL 33431
(561) 350-6975
✔ PECOS✔ Accepts Medicare0.1 mi
Kathleen Herne, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1871565648
1840 FOREST HILL BLVD SUITE 102
West Palm Beach, FL 33406
(561) 964-6664
✔ PECOS✔ Accepts Medicare18 mi
Alexandra Morquette, MD
Dermatology
NPI 1740921022
1611 NW 12TH AVE
Miami, FL 33136
(305) 585-1111
✔ PECOS42 mi
Alan Gold, M.D.
Plastic and Reconstructive Surgery
NPI 1497826887
833 NORTHERN BLVD SUITE 240
Great Neck, NY 11021
(516) 498-2800
✔ PECOS1,057 mi

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 10D2141186

Sanctuary Medical Aesthetic Center Of Boca Raton LLC · Boca Raton, FL
Active · expires Jan 15, 2028
CLIA Number10D2141186
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2026
Certificate Expiration DateJanuary 15, 2028
Laboratory DirectorKathleen Herne
Laboratory Phone(561) 886-0970
Laboratory LocationSanctuary Medical Aesthetic Center Of Boca Raton LLC4800 N Federal Hwy C100, Boca Raton, FL 33431
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 Sanctuary Medical Aesthetic Center Of Boca Raton LLC's NPI number?

The NPI number for Sanctuary Medical Aesthetic Center Of Boca Raton LLC is 1104282714. It was assigned to this organization in the NPPES registry on January 12, 2016.

Where is Sanctuary Medical Aesthetic Center Of Boca Raton LLC located?

Sanctuary Medical Aesthetic Center Of Boca Raton LLC is located at 4800 N Federal Hwy Suite C100, Boca Raton, FL 33431. The listed phone number is (561) 886-0970.

What is Sanctuary Medical Aesthetic Center Of Boca Raton LLC's specialty?

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

Is Sanctuary Medical Aesthetic Center Of Boca Raton LLC enrolled in Medicare?

Yes. Sanctuary Medical Aesthetic Center Of Boca Raton LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sanctuary Medical Aesthetic Center Of Boca Raton LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Sanctuary Medical Aesthetic Center Of Boca Raton LLC, in Dermatology, Micrographic Dermatologic Surgery (MDS) and Plastic and Reconstructive Surgery. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Sanctuary Medical Aesthetic Center Of Boca Raton LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D2141186) is associated with this NPI, valid through January 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sanctuary Medical Aesthetic Center Of Boca Raton LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Sanctuary Medical Aesthetic Center Of Boca Raton 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 Sanctuary Medical Aesthetic Center Of Boca Raton LLC was last updated on May 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.