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WATER'S EDGE DERMATOLOGY, LLC
NPI 1134148992
Dermatology in Palm Beach Gardens, FL

Active since July 19, 2006CLIA Certified · 6 labs
600 VILLAGE SQUARE CROSSING, PALM BEACH GARDENS, FL 33410(561) 694-9493(561) 694-9064 Get Directions Write a Review

NPPES record last updated: December 11, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 11, 2015, Nov 23, 2015 (2 updates tracked since 2015).

About Water's Edge Dermatology, Llc NPPES

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

WATER'S EDGE DERMATOLOGY, LLC (NPI 1134148992), doing business as Water's Edge Dermatology, Inc, is a healthcare organization registered as a dermatology in Palm Beach Gardens, Florida and active in the NPI registry since July 2006. The organization holds 6 active CLIA laboratory certificates and lists Susan Davis, Dir. Billing Ops, as its authorized official.

NPPES Registry Identity

NPI1134148992
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWATER'S EDGE DERMATOLOGY, LLC
Location Address600 VILLAGE SQUARE CROSSINGPalm Beach Gardens, FL 33410
Mailing Address600 Village Square CrossingPalm Beach Gardens, FL 33410 · (561) 693-0540 · Fax (561) 296-6174
Phone(561) 694-9493
Fax(561) 694-9064
Organization SubpartNo
Authorized OfficialSusan DavisDir. Billing Ops · (561) 693-0540
Enumeration DateJuly 19, 2006
Last NPPES UpdateDecember 11, 20152 updates tracked since enumeration
✔ NPI 1134148992 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.
600 VILLAGE SQUARE CROSSING, Palm Beach Gardens, FL 33410
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Other Names 1

Former Legal Business NameWater's Edge Dermatology, Inc

Other Identifiers 7

Other38243FL · Bcbs
Medicare PINK1053AFL
Medicare PINK1053BFL
Medicare PINK1053CFL
Medicare PINK1053FL
Medicare PINK1053DFL
Medicare PINK1053EFL

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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Molina Healthcare.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)

Water's Edge Dermatology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

59

Medicare enrollment records show 59 clinicians reassign Medicare billing to Water's Edge Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 13 practice at this address and 15 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Dermatology37
Nurse Practitioner15
Plastic and Reconstructive Surgery2
Radiation Oncology2
Cardiovascular Disease (Cardiology)1
General Surgery1
Internal Medicine1

Nearest to this location (20)

See all 59
Justin Platzer, M.D.
Dermatology
NPI 1487834693
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Geraldine Emanuel, ARNP
Nurse Practitioner
NPI 1023065083
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Kellie Mosley Mendez, D.O.
Dermatology
NPI 1386694388
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts MedicareSame address
Alissa O'brien, M.D.
Dermatology
NPI 1538394960
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Theodore Schiff, MD
Dermatology
NPI 1043276124
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Christopher Spock, MD
Dermatology
NPI 1679705677
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Shanna Stone, ARNP
Nurse Practitioner
NPI 1619282514
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Sydney Vanhoose, ARNP
Nurse Practitioner
NPI 1386008373
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts MedicareSame address
Ronald Bush, M.D.
Cardiovascular Disease (Cardiology)
NPI 1578565461
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts MedicareSame address
Laura Greyling, MD
Dermatology
NPI 1255620233
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
David Herold, M.D.
Radiation Oncology
NPI 1306873724
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts MedicareSame address
Rachelle Lacey
Dermatology
NPI 1740669605
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 694-9493
✔ PECOS✔ Accepts MedicareSame address
Kerry Shaughnessy, M.D.
Dermatology
NPI 1336438753
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts MedicareSame address
Jenna Minni, ARNP, FNP-BC
Nurse Practitioner
NPI 1134582711
875 MILITARY TRL STE 200
Jupiter, FL 33458
(561) 746-2110
✔ PECOS✔ Accepts Medicare6.5 mi
Laurie Lenz, DO
Dermatology
NPI 1073849147
2031 PALM BEACH LAKES BLVD #101
West Palm Beach, FL 33409
(561) 296-7710
✔ PECOS✔ Accepts Medicare8.4 mi
Charles Griff, M.D., P.A.
Dermatology
NPI 1043262637
3400 FOREST HILL BLVD
West Palm Beach, FL 33406
(561) 357-5636
✔ PECOS✔ Accepts Medicare13 mi
Dana Holl, M.D.
Dermatology
NPI 1467406876
3400 FOREST HILL BLVD
West Palm Beach, FL 33406
(561) 357-5636
✔ PECOS✔ Accepts Medicare13 mi
Elizabeth Leen-Burns, ARNP
Nurse Practitioner
NPI 1871779561
3400 FOREST HILL BLVD
West Palm Beach, FL 33406
(561) 357-5636
✔ PECOS✔ Accepts Medicare13 mi
Juan Zapata, M.D.
Internal Medicine
NPI 1184668618
12797 FOREST HILL BLVD STE B
Wellington, FL 33414
(561) 467-5232
✔ PECOS16 mi
Kelli Bryant, M.D.
Dermatology
NPI 1881127108
121 S STATE ROAD 7
Wellington, FL 33414
(561) 463-5923
✔ PECOS✔ Accepts Medicare17 mi
See all 59 clinicians

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 7

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 10D0272724

Aqua Dermatology Of Florida PA Dba Waters Edge Dermatology · Ocala, FL
Active · expires Aug 16, 2028
CLIA Number10D0272724
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorTheodore A. Schiff
Laboratory Phone(561) 694-9493
Laboratory LocationAqua Dermatology Of Florida PA Dba Waters Edge Dermatology2910 SE Third Ct, Ocala, FL 34471
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D2177456

Aqua Dermatology Of Florida PA Dba Waters Edge Dermatology · Merritt Island, FL
Active · expires Jul 29, 2028
CLIA Number10D2177456
Laboratory TypePhysician Office
Certificate Effective DateJuly 30, 2026
Certificate Expiration DateJuly 29, 2028
Laboratory DirectorChristopher R. Spock
Laboratory Phone(561) 694-9493
Laboratory LocationAqua Dermatology Of Florida PA Dba Waters Edge Dermatology1730 E Merritt Island Causeway, Merritt Island, FL 32952
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D0992082

Aqua Dermatology Of Florida PA Dba Waters Edge Dermatology · Fort Pierce, FL
Active · expires Jun 10, 2028
CLIA Number10D0992082
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorJason L. Lockridge
Laboratory Phone(561) 694-9493
Laboratory LocationAqua Dermatology Of Florida PA Dba Waters Edge Dermatology5101 Okeechobee Rd Ste 101, Fort Pierce, FL 34947
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 10D2002306

Aqua Dermatology Of Florida PA Dba Waters Edge Dermatology · Atlantis, FL
Active · expires May 31, 2028
CLIA Number10D2002306
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2026
Certificate Expiration DateMay 31, 2028
Laboratory DirectorDr. Julie Forero
Laboratory Phone(561) 694-9493
Laboratory LocationAqua Dermatology Of Florida PA Dba Waters Edge Dermatology160 John F Kennedy Dr Ste 204, Atlantis, FL 33462
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 10D2178911

Aqua Dermatology Of Florida PA Dba Waters Edge Dermatology · Orlando, FL
Active · expires May 6, 2028
CLIA Number10D2178911
Laboratory TypePhysician Office
Certificate Effective DateMay 7, 2026
Certificate Expiration DateMay 6, 2028
Laboratory DirectorJordan S. Fabrikant
Laboratory Phone(561) 694-9493
Laboratory LocationAqua Dermatology Of Florida PA Dba Waters Edge Dermatology7605 Conroy Windermere Road, Orlando, FL 32835
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D2123440

Aqua Dermatology Of Florida PA Dba Waters Edge Dermatology · Orange City, FL
Active · expires Jan 21, 2028
CLIA Number10D2123440
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2026
Certificate Expiration DateJanuary 21, 2028
Laboratory DirectorJohn P. Minni
Laboratory Phone(561) 694-9493
Laboratory LocationAqua Dermatology Of Florida PA Dba Waters Edge Dermatology921 Town Center Drive # 200, Orange City, FL 32763
CLIA data matches this NPI record on: 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 Water's Edge Dermatology, LLC's NPI number?

The NPI number for Water's Edge Dermatology, LLC is 1134148992. It was assigned to this organization in the NPPES registry on July 19, 2006. The provider was formerly known as Water's Edge Dermatology, Inc.

Where is Water's Edge Dermatology, LLC located?

Water's Edge Dermatology, LLC is located at 600 Village Square Crossing, Palm Beach Gardens, FL 33410. The listed phone number is (561) 694-9493.

What is Water's Edge Dermatology, LLC's specialty?

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

Is Water's Edge Dermatology, LLC enrolled in Medicare?

Yes. Water's Edge Dermatology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Water's Edge Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 59 clinicians in 7 Medicare specialties reassign their Medicare billing to Water's Edge Dermatology, LLC. 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 (37), Nurse Practitioner (15) and Plastic and Reconstructive Surgery (2). Of these, 13 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Water's Edge Dermatology, LLC hold CLIA laboratory certificates?

Yes. 6 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.

What insurance does Water's Edge Dermatology, LLC accept?

Health plans from Ambetter Health, Ambetter of Alabama and Molina Healthcare list Water's Edge Dermatology, 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 Water's Edge Dermatology, LLC was last updated on December 11, 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.