1. Home
  2. Directory
  3. Texas
  4. Austin
  5. Dermatology
  6. NPI Profile

PRODERM PLLC
NPI 1184410987
Dermatology - MOHS-Micrographic Surgery in Austin, TX

Active since April 17, 2025CLIA 45D2327593 · Certificate of Compliance
4516 SETON CENTER PKWY, STE 150, AUSTIN, TX 78759(512) 535-6000(512) 610-0262 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Proderm Pllc NPPES

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

PRODERM PLLC (NPI 1184410987), doing business as Proderm Skin & Surgery, is a healthcare organization registered as a mohs-micrographic surgery in Austin, Texas and active in the NPI registry since April 2025. The organization holds a CLIA Certificate of Compliance certificate valid through July 23, 2027 and lists Sydney Larkin Proffer, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1184410987
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NamePRODERM PLLC
Location Address4516 SETON CENTER PKWY, STE 150Austin, TX 78759-5370
Mailing Address4516 Seton Center Pkwy, Ste 150Austin, TX 78759-5370 · (512) 535-6000 · Fax (512) 610-0262
Phone(512) 535-6000
Fax(512) 610-0262
Organization SubpartNo
Authorized OfficialSydney Larkin ProfferSole Member · (512) 535-6000
Enumeration DateApril 17, 2025
Last NPPES UpdateJune 17, 2025
NPPES CertifiedJune 17, 2025
✔ NPI 1184410987 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.
4516 SETON CENTER PKWY, Austin, TX 78759
Open in Google Maps ↗

Other Names 1

Doing Business AsProderm Skin & Surgery

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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 45D2327593

Proderm PLLC · Austin, TX
Active · expires Jul 23, 2027
CLIA Number45D2327593
Laboratory TypePhysician Office
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorSydney L. Proffer
Laboratory Phone(512) 535-6000
Laboratory LocationProderm PLLC4516 Seton Center Pkwy # 150, Austin, TX 78759
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

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

SYDNEY LARKIN PROFFER MD, MS
Dermatology (MOHS-Micrographic Surgery)
4516 SETON CENTER PKWY, STE 150
AUSTIN, TX 78759
Travis County (512) 535-6000

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 Proderm PLLC's NPI number?

The NPI number for Proderm PLLC is 1184410987. It was assigned to this organization in the NPPES registry on April 17, 2025. The provider is doing business as ProDerm Skin & Surgery.

Where is Proderm PLLC located?

Proderm PLLC is located at 4516 Seton Center Pkwy Ste 150, Austin, TX 78759. The listed phone number is (512) 535-6000.

What is Proderm PLLC's specialty?

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

Does Proderm PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D2327593) is associated with this NPI, valid through July 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Proderm PLLC accept?

Health plans from Blue Cross and Blue Shield of Texas list Proderm PLLC 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 Proderm PLLC was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.