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LUXE DERMATOLOGY AND AESTHETIC CENTER, PLLC
NPI 1174186100
Dermatology in Mc Lean, VA

Active since April 16, 2019CLIA 49D2179628 · Waiver
8200 GREENSBORO DR STE 801, MC LEAN, VA 22102(703) 942-9787(703) 563-3824 Get Directions Write a Review

NPPES record last updated: March 12, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 12, 2020, Apr 16, 2019 (2 updates tracked since 2019).

About Luxe Dermatology And Aesthetic Center, Pllc NPPES

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

LUXE DERMATOLOGY AND AESTHETIC CENTER, PLLC (NPI 1174186100) is a healthcare organization registered as a dermatology in Mc Lean, Virginia and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through July 17, 2028 and lists Liza Moore, Owner, as its authorized official.

NPPES Registry Identity

NPI1174186100
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLUXE DERMATOLOGY AND AESTHETIC CENTER, PLLC
Location Address8200 GREENSBORO DR STE 801Mc Lean, VA 22102-4925
Mailing Address8200 Greensboro Dr Ste 801Mc Lean, VA 22102-4925 · (703) 942-9787 · Fax (703) 563-3824
Phone(703) 942-9787
Fax(703) 563-3824
Organization SubpartNo
Authorized OfficialLiza MooreOwner · (919) 274-4199
Enumeration DateApril 16, 2019
Last NPPES UpdateMarch 12, 20202 updates tracked since enumeration
NPPES CertifiedMarch 12, 2020
✔ NPI 1174186100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
8200 GREENSBORO DR STE 801, Mc Lean, VA 22102
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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)

Luxe Dermatology And Aesthetic Center, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Luxe Dermatology And Aesthetic Center, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Liza Moore, MD
Dermatology
NPI 1730405010
8200 GREENSBORO DR STE 801
Mc Lean, VA 22102
(703) 942-9787
✔ PECOS✔ Accepts MedicareSame address
Reem Tadros, M.D.
Dermatology
NPI 1205934213
3700 JOSEPH SIEWICK DR SUITE 403
Fairfax, VA 22033
(703) 648-2488
✔ PECOS✔ Accepts Medicare8.7 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

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 Waiver 49D2179628

Luxe Dermatology And Aesthetic Center, PLLC · Mclean, VA
Active · expires Jul 17, 2028
CLIA Number49D2179628
Laboratory TypePhysician Office
Certificate Effective DateJuly 18, 2026
Certificate Expiration DateJuly 17, 2028
Laboratory DirectorLiza Moore
Laboratory Phone(703) 942-9787
Laboratory LocationLuxe Dermatology And Aesthetic Center, PLLC8200 Greensboro Dr, Suite 801, Mclean, VA 22102
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only 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 Luxe Dermatology And Aesthetic Center, PLLC's NPI number?

The NPI number for Luxe Dermatology And Aesthetic Center, PLLC is 1174186100. It was assigned to this organization in the NPPES registry on April 16, 2019.

Where is Luxe Dermatology And Aesthetic Center, PLLC located?

Luxe Dermatology And Aesthetic Center, PLLC is located at 8200 Greensboro Dr Ste 801, Mc Lean, VA 22102. The listed phone number is (703) 942-9787.

What is Luxe Dermatology And Aesthetic Center, PLLC's specialty?

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

Is Luxe Dermatology And Aesthetic Center, PLLC enrolled in Medicare?

Yes. Luxe Dermatology And Aesthetic Center, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Luxe Dermatology And Aesthetic Center, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Luxe Dermatology And Aesthetic Center, PLLC. 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 at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Luxe Dermatology And Aesthetic Center, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2179628) is associated with this NPI, valid through July 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Luxe Dermatology And Aesthetic Center, PLLC was last updated on March 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.