CENTRAL TEXAS DERMATOLOGY, PA
NPI 1164566246
Specialist in West Lake Hills, TX
About Central Texas Dermatology, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CENTRAL TEXAS DERMATOLOGY, PA (NPI 1164566246) is a healthcare organization registered as a specialist in West Lake Hills, Texas and active in the NPI registry since February 2007. The organization holds a CLIA Certificate of Compliance certificate valid through July 14, 2027 and lists Debra Petrie, Biller/credentialer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Central Texas Dermatology, Pa 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
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Central Texas Dermatology, PA, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
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 45D0505556
Central Texas Dermatology · Austin, TXFrequently 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 Central Texas Dermatology, PA's NPI number?
The NPI number for Central Texas Dermatology, PA is 1164566246. It was assigned to this organization in the NPPES registry on February 20, 2007.
Where is Central Texas Dermatology, PA located?
Central Texas Dermatology, PA is located at 102 Westlake Dr #100, West Lake Hills, TX 78746. The listed phone number is (512) 327-7779.
What is Central Texas Dermatology, PA's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Central Texas Dermatology, PA enrolled in Medicare?
Yes. Central Texas Dermatology, PA is registered in the Medicare PECOS enrollment system.
When is Central Texas Dermatology, PA'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 (Texas, 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 Central Texas Dermatology, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 4 Medicare specialties reassign their Medicare billing to Central Texas Dermatology, PA. 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 (4), Micrographic Dermatologic Surgery (MDS) (2) and Nurse Practitioner (2). Of these, 5 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Central Texas Dermatology, PA hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 45D0505556) is associated with this NPI, valid through July 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Central Texas Dermatology, PA accept?
Health plans from Moda Health Plan, Inc. list Central Texas Dermatology, PA 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 Central Texas Dermatology, PA was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Central Texas Dermatology, Pa · NPI 1164566246
Specialist organization in West Lake Hills, Texas. Organization record, active in the CMS NPPES registry since February 20, 2007.
## Identity
- **NPI:** 1164566246 (Entity type: Organization)
- **Enumerated:** February 20, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Debra Petrie, BILLER/CREDENTIALER
## Practice location
- **Address:** 102 WESTLAKE DR, #100, West Lake Hills, TX 78746
- **Phone:** (512) 327-7779
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 9 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (4), Micrographic Dermatologic Surgery (MDS) (2), Nurse Practitioner (2); 5 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 13, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164566246) · Data from the CMS NPPES public registry.