AFFILIATED DERMATOLOGY, PC
NPI 1124008636
Dermatology - Procedural Dermatology in Dothan, AL
About Affiliated Dermatology, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AFFILIATED DERMATOLOGY, PC (NPI 1124008636) is a healthcare organization registered as a procedural dermatology in Dothan, Alabama and active in the NPI registry since January 2006. The organization holds a CLIA Certificate of Compliance certificate valid through April 22, 2028 and lists Lois W Sallas, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Accepted 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)
Affiliated Dermatology, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Affiliated Dermatology, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (10)
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 01D0304727
Affiliated Dermatology · Dothan, ALFrequently 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 Affiliated Dermatology, PC's NPI number?
The NPI number for Affiliated Dermatology, PC is 1124008636. It was assigned to this organization in the NPPES registry on January 19, 2006.
Where is Affiliated Dermatology, PC located?
Affiliated Dermatology, PC is located at 4300 W Main St Suite 102, Dothan, AL 36305. The listed phone number is (334) 793-9564.
What is Affiliated Dermatology, PC's specialty?
The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.
Is Affiliated Dermatology, PC enrolled in Medicare?
Yes. Affiliated Dermatology, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Affiliated Dermatology, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 3 Medicare specialties reassign their Medicare billing to Affiliated Dermatology, PC. 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 (4), Nurse Practitioner (4) and Radiation Oncology (2). Of these, 2 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Affiliated Dermatology, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 01D0304727) is associated with this NPI, valid through April 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Affiliated Dermatology, PC accept?
Health plans from Ambetter Health, Ambetter of Alabama and Ambetter of Tennessee list Affiliated Dermatology, PC 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 Affiliated Dermatology, PC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Affiliated Dermatology, Pc · NPI 1124008636
Procedural Dermatology organization in Dothan, Alabama. Organization record, active in the CMS NPPES registry since January 19, 2006.
## Identity
- **NPI:** 1124008636 (Entity type: Organization)
- **Enumerated:** January 19, 2006
- **Primary specialty:** Dermatology - Procedural Dermatology · taxonomy 207NS0135X
- **Organization subpart:** No
- **Authorized official:** Lois Sallas, ADMINISTRATOR
## Practice location
- **Address:** 4300 W MAIN ST, SUITE 102, Dothan, AL 36305-1054
- **Phone:** (334) 793-9564 · **Fax:** (334) 671-8907
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (4), Nurse Practitioner (4), Radiation Oncology (2); 2 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124008636) · Data from the CMS NPPES public registry.