HEIDELBERG DERMATOLOGY, P.C.
NPI 1124045075
Dermatology in Detroit, MI
About Heidelberg Dermatology, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HEIDELBERG DERMATOLOGY, P.C. (NPI 1124045075) is a healthcare organization registered as a dermatology in Detroit, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Microscopy certificate valid through March 26, 2027 and lists Karen A. Heidelberg, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Heidelberg Dermatology, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Heidelberg Dermatology, P.C., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 for Provider-Performed Microscopy Procedures (PPMP) 23D0868799
Heidelberg Dermatology PC · Detroit, MIFrequently 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 Heidelberg Dermatology, P.C.'s NPI number?
The NPI number for Heidelberg Dermatology, P.C. is 1124045075. It was assigned to this organization in the NPPES registry on July 16, 2006.
Where is Heidelberg Dermatology, P.C. located?
Heidelberg Dermatology, P.C. is located at 20400 Livernois Ave, Detroit, MI 48221. The listed phone number is (313) 341-4514.
What is Heidelberg Dermatology, P.C.'s specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Heidelberg Dermatology, P.C. enrolled in Medicare?
Yes. Heidelberg Dermatology, P.C. is registered in the Medicare PECOS enrollment system.
When is Heidelberg Dermatology, P.C.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Heidelberg Dermatology, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Heidelberg Dermatology, P.C., in Dermatology and Internal Medicine. 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 at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Heidelberg Dermatology, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0868799) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Heidelberg Dermatology, P.C. accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Heidelberg Dermatology, P.C. 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 Heidelberg Dermatology, P.C. was last updated on December 2, 2015. 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.
# Heidelberg Dermatology, P.c. · NPI 1124045075
Dermatology organization in Detroit, Michigan. Organization record, active in the CMS NPPES registry since July 16, 2006.
## Identity
- **NPI:** 1124045075 (Entity type: Organization)
- **Enumerated:** July 16, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Karen Heidelberg, PRESIDENT
## Practice location
- **Address:** 20400 LIVERNOIS AVE, Detroit, MI 48221-1348
- **Phone:** (313) 341-4514 · **Fax:** (313) 341-2152
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (2), Internal Medicine (1); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 2, 2015
- **Other identifiers:** Other 0H28011 (MI); Medicare PIN 0H28011 (MI); Medicare ID-Type Unspecified 0H28011 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124045075) · Data from the CMS NPPES public registry.