UNIVERSITY OF MARYLAND DERMATOLOGISTS PA
NPI 1104623867
Dermatology in Lutherville, MD
About University Of Maryland Dermatologists Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UNIVERSITY OF MARYLAND DERMATOLOGISTS PA (NPI 1104623867) is a healthcare organization registered as a dermatology in Lutherville, Maryland and active in the NPI registry since February 2025. The organization holds 4 active CLIA laboratory certificates and lists Shavonda L Williams, Corporate Director Professional Fee, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
University Of Maryland Dermatologists Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
20Medicare enrollment records show 20 clinicians reassign Medicare billing to University Of Maryland Dermatologists PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 11 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (20)
Bethesda, MD 20892
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 4
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 for Provider-Performed Microscopy Procedures (PPMP) 21D2133919
University Of Maryland Dermatologists, PA · Baltimore, MDCertificate of Compliance 21D2330830
University Of Maryland Dermatology · Ellicott City, MDCertificate of Compliance 21D2321219
University Of Maryland Dermatology · Ellicott City, MDCertificate for Provider-Performed Microscopy Procedures (PPMP) 21D2133977
University Of Maryland Dermatology, PA · Columbia, MDFrequently 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 University Of Maryland Dermatologists PA's NPI number?
The NPI number for University Of Maryland Dermatologists PA is 1104623867. It was assigned to this organization in the NPPES registry on February 28, 2025.
Where is University Of Maryland Dermatologists PA located?
University Of Maryland Dermatologists PA is located at 1447 York Rd Ste 102, Lutherville, MD 21093. The listed phone number is (667) 214-1171.
What is University Of Maryland Dermatologists PA's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is University Of Maryland Dermatologists PA enrolled in Medicare?
Yes. University Of Maryland Dermatologists PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through University Of Maryland Dermatologists PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 20 clinicians in 3 Medicare specialties reassign their Medicare billing to University Of Maryland Dermatologists PA. 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 (17), Nurse Practitioner (2) and Pathology (1). Of these, 2 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does University Of Maryland Dermatologists PA hold CLIA laboratory certificates?
Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for University Of Maryland Dermatologists PA was last updated on February 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.
# University Of Maryland Dermatologists Pa · NPI 1104623867
Dermatology organization in Lutherville, Maryland. Organization record, active in the CMS NPPES registry since February 28, 2025.
## Identity
- **NPI:** 1104623867 (Entity type: Organization)
- **Enumerated:** February 28, 2025
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Shavonda Williams, CORPORATE DIRECTOR PROFESSIONAL FEE
## Practice location
- **Address:** 1447 YORK RD STE 102, Lutherville, MD 21093-6017
- **Phone:** (667) 214-1171
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 20 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (17), Nurse Practitioner (2), Pathology (1); 2 practice at this address and 11 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 28, 2025
- **CLIA laboratory certificates:** 4 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104623867) · Data from the CMS NPPES public registry.