GREENBRAE DERMATOLOGY, A MEDICAL CORPORATION
NPI 1174898654
Dermatology in Greenbrae, CA
About Greenbrae Dermatology, A Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREENBRAE DERMATOLOGY, A MEDICAL CORPORATION (NPI 1174898654) is a healthcare organization registered as a dermatology in Greenbrae, California and active in the NPI registry since March 2012. The organization holds a CLIA Certificate of Compliance certificate valid through December 31, 2026 and lists Lucretia Ann Lewitt, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Greenbrae Dermatology, A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Greenbrae Dermatology, A Medical Corporation, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
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 05D0686425
Greenbrae Dermatology Amc · Greenbrae, CAFrequently 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 Greenbrae Dermatology, A Medical Corporation's NPI number?
The NPI number for Greenbrae Dermatology, A Medical Corporation is 1174898654. It was assigned to this organization in the NPPES registry on March 15, 2012.
Where is Greenbrae Dermatology, A Medical Corporation located?
Greenbrae Dermatology, A Medical Corporation is located at 1300 S Eliseo Dr Ste 207, Greenbrae, CA 94904. The listed phone number is (415) 925-0550.
What is Greenbrae Dermatology, A Medical Corporation's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Greenbrae Dermatology, A Medical Corporation enrolled in Medicare?
Yes. Greenbrae Dermatology, A Medical Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Greenbrae Dermatology, A Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Greenbrae Dermatology, A Medical Corporation. 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 (6) and Otolaryngology (1). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Greenbrae Dermatology, A Medical Corporation hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 05D0686425) is associated with this NPI, valid through December 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Greenbrae Dermatology, A Medical Corporation was last updated on June 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Greenbrae Dermatology, A Medical Corporation · NPI 1174898654
Dermatology organization in Greenbrae, California. Organization record, active in the CMS NPPES registry since March 15, 2012.
## Identity
- **NPI:** 1174898654 (Entity type: Organization)
- **Enumerated:** March 15, 2012
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Lucretia Lewitt, PRACTICE MANAGER
## Practice location
- **Address:** 1300 S ELISEO DR STE 207, Greenbrae, CA 94904-2015
- **Phone:** (415) 925-0550 · **Fax:** (415) 925-9062
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (6), Otolaryngology (1); 2 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 30, 2015
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174898654) · Data from the CMS NPPES public registry.