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COASTAL DERMATOLOGY INSTITUTE LLC
NPI 1174122444
Dermatology - MOHS-Micrographic Surgery in Myrtle Beach, SC

Active since October 19, 2020
199 VILLAGE CENTER BLVD STE 200, MYRTLE BEACH, SC 29579(843) 738-0500 Get Directions Write a Review

NPPES record last updated: June 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 2, 2021, Oct 19, 2020 (2 updates tracked since 2020).

About Coastal Dermatology Institute Llc NPPES

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

COASTAL DERMATOLOGY INSTITUTE LLC (NPI 1174122444) is a healthcare organization registered as a mohs-micrographic surgery in Myrtle Beach, South Carolina and active in the NPI registry since October 2020. The organization lists Michael Centilli, Owner, as its authorized official.

NPPES Registry Identity

NPI1174122444
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameCOASTAL DERMATOLOGY INSTITUTE LLC
Location Address199 VILLAGE CENTER BLVD STE 200Myrtle Beach, SC 29579-3589
Mailing Address199 Village Center Blvd Ste 200Myrtle Beach, SC 29579-3589
Phone(843) 738-0500
Organization SubpartNo
Authorized OfficialMichael CentilliOwner · (517) 203-6532
Enumeration DateOctober 19, 2020
Last NPPES UpdateJune 2, 20212 updates tracked since enumeration
NPPES CertifiedJune 2, 2021
✔ NPI 1174122444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
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.
199 VILLAGE CENTER BLVD STE 200, Myrtle Beach, SC 29579
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina.Insurance ›

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 42D2228091

Coastal Dermatology Institute · Myrtle Beach, SC
Expired · Jul 31, 2026
CLIA Number42D2228091
Laboratory TypePhysician Office
Certificate Effective DateMay 24, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorDr. Michael R. Centilli
Laboratory Phone(843) 738-0500
Laboratory LocationCoastal Dermatology Institute199 Village Center Blvd, Suite 200, Myrtle Beach, SC 29579
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL ROBERT CENTILLI D.O.
Dermatology
199 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH, SC 29579
Horry County (843) 738-0500
LINDSAY MARIE JOHNSON PA
Physician Assistant (Medical)
199 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH, SC 29579
Horry County (843) 738-0500

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 Coastal Dermatology Institute LLC's NPI number?

The NPI number for Coastal Dermatology Institute LLC is 1174122444. It was assigned to this organization in the NPPES registry on October 19, 2020.

Where is Coastal Dermatology Institute LLC located?

Coastal Dermatology Institute LLC is located at 199 Village Center Blvd Ste 200, Myrtle Beach, SC 29579. The listed phone number is (843) 738-0500.

What is Coastal Dermatology Institute LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

What insurance does Coastal Dermatology Institute LLC accept?

Health plans from Ambetter from Absolute Total Care and Ambetter of North Carolina list Coastal Dermatology Institute 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 Coastal Dermatology Institute LLC was last updated on June 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.