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LEGACY DERMATOLOGY, PLLC
NPI 1134588148
Dermatology in Frisco, TX

Active since February 18, 2016CLIA Certified · 2 labs
1360 DEER LAKE DR, FRISCO, TX 75034(214) 799-6367 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 1, 2017, Feb 18, 2016 (2 updates tracked since 2016).

About Legacy Dermatology, Pllc NPPES

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

LEGACY DERMATOLOGY, PLLC (NPI 1134588148) is a healthcare organization registered as a dermatology in Frisco, Texas and active in the NPI registry since February 2016. The organization holds 2 active CLIA laboratory certificates and lists Jennifer Warner Dharamsi, Owner, as its authorized official.

NPPES Registry Identity

NPI1134588148
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEGACY DERMATOLOGY, PLLC
Location Address1360 DEER LAKE DRFrisco, TX 75034-1731
Mailing Address3140 Legacy Dr, Suite 110Frisco, TX 75034 · (972) 469-2626
Phone(214) 799-6367
Organization SubpartNo
Authorized OfficialJennifer Warner DharamsiOwner · (972) 469-2626
Enumeration DateFebruary 18, 2016
Last NPPES UpdateMarch 25, 20222 updates tracked since enumeration
NPPES CertifiedMarch 25, 2022
✔ NPI 1134588148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in TX · P2228
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.
1360 DEER LAKE DR, Frisco, TX 75034
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Legacy Dermatology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Legacy Dermatology, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Jennifer Dharamsi, M.D.
Dermatology
NPI 1255507794
3140 LEGACY DRIVE SUITE 110
Frisco, TX 75034
(972) 469-2626
✔ PECOS✔ Accepts Medicare2.6 mi
Max Adler, MD
Dermatology
NPI 1801835434
6117 BERKSHIRE LN
Dallas, TX 75225
(214) 692-7447
✔ PECOS✔ Accepts Medicare18 mi
Jonathan Nathan, M.D.
Plastic and Reconstructive Surgery
NPI 1134449374
3900 JUNIUS ST STE 605
Dallas, TX 75246
(214) 814-1711
✔ PECOS✔ Accepts Medicare24 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 2

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 45D2171402

Legacy Dermatology, PLLC · Frisco, TX
Active · expires Sep 27, 2027
CLIA Number45D2171402
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2025
Certificate Expiration DateSeptember 27, 2027
Laboratory DirectorDr. Jennifer Dharamsi
Laboratory Phone(214) 617-1778
Laboratory LocationLegacy Dermatology, PLLC3140 Legacy Dr Suite 620, Frisco, TX 75034
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D2129496

Legacy Dermatology · Frisco, TX
Active · expires Apr 19, 2027
CLIA Number45D2129496
Laboratory TypePhysician Office
Certificate Effective DateApril 20, 2025
Certificate Expiration DateApril 19, 2027
Laboratory DirectorJennifer W. Dharamsi
Laboratory Phone(214) 618-1778
Laboratory LocationLegacy Dermatology3140 Legacy Drive, Suite 110, Frisco, TX 75034
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Legacy Dermatology, PLLC's NPI number?

The NPI number for Legacy Dermatology, PLLC is 1134588148. It was assigned to this organization in the NPPES registry on February 18, 2016.

Where is Legacy Dermatology, PLLC located?

Legacy Dermatology, PLLC is located at 1360 Deer Lake Dr, Frisco, TX 75034. The listed phone number is (214) 799-6367.

What is Legacy Dermatology, PLLC's specialty?

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

Is Legacy Dermatology, PLLC enrolled in Medicare?

Yes. Legacy Dermatology, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Legacy Dermatology, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Legacy Dermatology, PLLC, in Dermatology and Plastic and Reconstructive Surgery. 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 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Legacy Dermatology, PLLC hold CLIA laboratory certificates?

Yes. 2 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.

When was this NPI record last updated?

The NPPES record for Legacy Dermatology, PLLC was last updated on March 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.