RIVER CITY DERMATOLOGY PLLC
NPI 1124906433
Dermatology in Jacksonville Beach, FL
About River City Dermatology Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RIVER CITY DERMATOLOGY PLLC (NPI 1124906433) is a healthcare organization registered as a dermatology in Jacksonville Beach, Florida and active in the NPI registry since August 2025. The organization holds a CLIA Microscopy certificate valid through January 19, 2028 and lists Sima D Amin, Owner, 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)
River City Dermatology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to River City Dermatology PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Jacksonville Beach, FL 32250
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) 10D2337217
River City Dermatology PLLC · Jacksonville Beach, FLFrequently 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 River City Dermatology PLLC's NPI number?
The NPI number for River City Dermatology PLLC is 1124906433. It was assigned to this organization in the NPPES registry on August 25, 2025.
Where is River City Dermatology PLLC located?
River City Dermatology PLLC is located at 1361 13th Ave S Ste 140, Jacksonville Beach, FL 32250. The listed phone number is (904) 372-8031.
What is River City Dermatology PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is River City Dermatology PLLC enrolled in Medicare?
Yes. River City Dermatology PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through River City Dermatology PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to River City Dermatology PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does River City Dermatology PLLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 10D2337217) is associated with this NPI, valid through January 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for River City Dermatology PLLC was last updated on January 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.