COASTAL DERMATOLOGY INSTITUTE LLC
NPI 1174122444
Dermatology - MOHS-Micrographic Surgery in Myrtle Beach, SC
NPI Status: Active since October 19, 2020
Contact Information
199 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 738-0500
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- Accepts Insurance
- CLIA Number: 42D2228091
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-31-2026
About COASTAL DERMATOLOGY INSTITUTE LLC
This page provides the complete NPI Profile along with additional information for Coastal Dermatology Institute Llc, a provider established in Myrtle Beach, South Carolina operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1174122444 assigned on October 2020. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Michael Centilli Do (Owner)
- NPI
- 1174122444
- Provider Name
- COASTAL DERMATOLOGY INSTITUTE LLC
- Entity Type
- Organization
- Location Address
- 199 VILLAGE CENTER BLVD STE 200 MYRTLE BEACH, SC 29579
- Location Phone
- (843) 738-0500
- Mailing Address
- 199 VILLAGE CENTER BLVD STE 200 MYRTLE BEACH, SC 29579
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-19-2020
- Last Update Date
- 06-02-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Bronze with Atrium Health - HMO
- Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
- Focused Silver with Atrium Health - HMO
- Focused Silver with Atrium Health + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze with Atrium Health - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D2228091
- Facility Type
- Physician Office
- Certificate Effective Date
- May 24, 2024
- Certificate Expiration Date
- May 31, 2026
- Laboratory Director
- DR. MICHAEL R. CENTILLI
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Coastal Dermatology Institute Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174122444, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
MYRTLE BEACH, SC 29579
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174122444, enumerated as an "organization" on October 19, 2020.
The provider is located at 199 VILLAGE CENTER BLVD STE 200 MYRTLE BEACH, SC 29579 and the phone number is (843) 738-0500.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
The provider might be accepting Accepts: Ambetter from Absolute Total Care and Ambetter of. Please consult your insurance carrier or call the provider to verify.
