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

Q: 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.

Q: 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.

Active since October 19, 2020CLIA 42D2228091 · Certificate of Compliance

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: November 01, 2026.

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

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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 holds a CLIA Certificate of Compliance certificate valid through May 23, 2028 and 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 Health, Ambetter of North Carolina and more.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)

Coastal Dermatology Institute Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Coastal Dermatology Institute LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Centilli, D.O.

Dermatology

NPI 1215223326

199 VILLAGE CENTER BLVD STE 200
Myrtle Beach, SC 29579

(843) 738-0500

✔ PECOS✔ Accepts MedicareSame address

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 42D2228091

Coastal Dermatology Institute · Myrtle Beach, SC

Active · expires May 23, 2028

CLIA Number42D2228091

Laboratory TypePhysician Office

Certificate Effective DateMay 24, 2026

Certificate Expiration DateMay 23, 2028

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.

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.

Is Coastal Dermatology Institute LLC enrolled in Medicare?

Yes. Coastal Dermatology Institute LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Coastal Dermatology Institute LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Coastal Dermatology Institute 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Coastal Dermatology Institute LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 42D2228091) is associated with this NPI, valid through May 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Coastal Dermatology Institute LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and BlueCross BlueShield of South 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.