1. Home
  2. Directory
  3. Connecticut
  4. Simsbury
  5. Dermatology
  6. NPI Profile

INTEGRATED DERMATOLOGY OF ENFIELD, LLC
NPI 1134544661
Dermatology in Simsbury, CT

Active since February 20, 2014CLIA 07D2161990 · Certificate of Compliance
714 HOPMEADOW ST STE 5, SIMSBURY, CT 06070(860) 741-2225(860) 651-1404 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 11, 2025, Jan 14, 2019 (2 updates tracked since 2019).

About Integrated Dermatology Of Enfield, Llc NPPES

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

INTEGRATED DERMATOLOGY OF ENFIELD, LLC (NPI 1134544661) is a healthcare organization registered as a dermatology in Simsbury, Connecticut and active in the NPI registry since February 2014. The organization holds a CLIA Certificate of Compliance certificate valid through January 7, 2028 and lists Jeffrey D Queen, Manager, as its authorized official.

NPPES Registry Identity

NPI1134544661
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF ENFIELD, LLC
Location Address714 HOPMEADOW ST STE 5Simsbury, CT 06070-2234
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000 · Fax (860) 651-1404
Phone(860) 741-2225
Fax(860) 651-1404
Organization SubpartNo
Authorized OfficialJeffrey D QueenManager · (561) 314-2000
Enumeration DateFebruary 20, 2014
Last NPPES UpdateJune 11, 20252 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
✔ NPI 1134544661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedSpecialistTaxonomy 174400000X
Also ListedPhysician AssistantTaxonomy 363A00000X
714 HOPMEADOW ST STE 5, Simsbury, CT 06070
Open in Google Maps ↗

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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)

Integrated Dermatology Of Enfield, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Integrated Dermatology Of Enfield, LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (5)

Maja Matwiejczuk, FNP APRN
Nurse Practitioner
NPI 1093276750
113 ELM STREET SUITE 304
Enfield, CT 06082
(860) 741-2225
✔ PECOS✔ Accepts Medicare14 mi
Meagen Mccusker, M.D.
Dermatology
NPI 1861651432
113 ELM STREET SUITE 304
Enfield, CT 06082
(860) 741-2225
✔ PECOS✔ Accepts Medicare14 mi
Kathryn Reinmann, DNP, FNP-BC
Nurse Practitioner
NPI 1255086864
113 ELM ST STE 304
Enfield, CT 06082
(860) 741-2225
✔ PECOS✔ Accepts Medicare14 mi
Michael Payette, M.D., M.B.A.
Dermatology
NPI 1952575573
1 WILLOWBROOK RD STE 2
Cromwell, CT 06416
(860) 322-2222
✔ PECOS✔ Accepts Medicare19 mi
Andrew Kelsey, MD
Dermatology
NPI 1649664731
1078 W MAIN ST
Waterbury, CT 06708
(203) 757-1585
✔ PECOS✔ Accepts Medicare26 mi

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 07D2161990

Integrated Dermatology Of Enfield · Simsbury, CT
Active · expires Jan 7, 2028
CLIA Number07D2161990
Laboratory TypePhysician Office
Certificate Effective DateJanuary 8, 2026
Certificate Expiration DateJanuary 7, 2028
Laboratory DirectorAndrew Kelsey
Laboratory Phone(860) 741-2225
Laboratory LocationIntegrated Dermatology Of Enfield714 Hopmeadow St Ste 5, Simsbury, CT 06070
CLIA data matches this NPI record on: Address Name 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 Integrated Dermatology Of Enfield, LLC's NPI number?

The NPI number for Integrated Dermatology Of Enfield, LLC is 1134544661. It was assigned to this organization in the NPPES registry on February 20, 2014.

Where is Integrated Dermatology Of Enfield, LLC located?

Integrated Dermatology Of Enfield, LLC is located at 714 Hopmeadow St Ste 5, Simsbury, CT 06070. The listed phone number is (860) 741-2225.

What is Integrated Dermatology Of Enfield, LLC's specialty?

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

Is Integrated Dermatology Of Enfield, LLC enrolled in Medicare?

Yes. Integrated Dermatology Of Enfield, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Dermatology Of Enfield, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Integrated Dermatology Of Enfield, 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 (3) and Nurse Practitioner (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Integrated Dermatology Of Enfield, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 07D2161990) is associated with this NPI, valid through January 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Integrated Dermatology Of Enfield, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Integrated Dermatology Of Enfield, 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 Integrated Dermatology Of Enfield, LLC was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.