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SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A.
NPI 1205270824
Specialist in Orange City, FL

Active since April 25, 2013
865 SAXON BLVD, ORANGE CITY, FL 32763(386) 256-1969(407) 599-7506 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Skin Dermatology And Cosmetic Services, P.a. NPPES

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

SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A. (NPI 1205270824) is a healthcare organization registered as a specialist in Orange City, Florida and active in the NPI registry since April 2013. The organization maintains 2 additional practice locations and lists Ross Charles Wheeler, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1205270824
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSKIN DERMATOLOGY AND COSMETIC SERVICES, P.A.
Location Address865 SAXON BLVDOrange City, FL 32763-8204
Mailing Address865 Saxon BlvdOrange City, FL 32763-8204 · (386) 256-1969 · Fax (407) 599-7506
Phone(386) 256-1969
Fax(407) 599-7506
Organization SubpartNo
Authorized OfficialRoss Charles WheelerMedical Director · (407) 599-7546
Enumeration DateApril 25, 2013
Last NPPES UpdateMarch 22, 2021
NPPES CertifiedMarch 22, 2021
✔ NPI 1205270824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME73845
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
865 SAXON BLVD, Orange City, FL 32763
Open in Google Maps ↗

Secondary Practice Locations 2

Location 14106 W Lake Mary Blvd Ste 325Lake Mary, FL 32746-3383 · Phone (386) 256-1969 · Fax (386) 960-7863
Location 284 Pinnacles Dr Ste 400Palm Coast, FL 32164-2324 · Phone (386) 256-1969 · Fax (386) 960-7863

Other Identifiers 1

Medicaid2608936FL

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 Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) 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)

Skin Dermatology And Cosmetic Services, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Skin Dermatology And Cosmetic Services, P.A., which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (6)

Jessica White, APRN-BC
Nurse Practitioner
NPI 1104391465
1035 PRIMERA BLVD
Lake Mary, FL 32746
(407) 333-3040
✔ PECOS✔ Accepts Medicare11 mi
George Papanicolaou, M.D.
Plastic and Reconstructive Surgery
NPI 1982895223
3272 W LAKE MARY BLVD STE 1810
Lake Mary, FL 32746
(407) 478-3151
✔ PECOS✔ Accepts Medicare11 mi
Ross Wheeler, M.D.
Dermatology
NPI 1316920747
451 MAITLAND AVE
Altamonte Springs, FL 32701
(407) 599-7546
✔ PECOS✔ Accepts Medicare18 mi
George Pope, M.D.
Plastic and Reconstructive Surgery
NPI 1063422566
1835 BISCAYNE DR
Orlando, FL 32804
(407) 234-0099
✔ PECOS✔ Accepts Medicare26 mi
Amy Federico, NP
Nurse Practitioner
NPI 1427159128
84 PINNACLES DR STE 400
Palm Coast, FL 32164
(386) 256-1969
✔ PECOS✔ Accepts Medicare39 mi
Kenneth Wallace, MD
Dermatology
NPI 1295791754
1091 SE 59TH ST
Ocala, FL 34480
(850) 597-0324
✔ PECOS✔ Accepts Medicare52 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Skin Dermatology And Cosmetic Services, P.A.'s NPI number?

The NPI number for Skin Dermatology And Cosmetic Services, P.A. is 1205270824. It was assigned to this organization in the NPPES registry on April 25, 2013.

Where is Skin Dermatology And Cosmetic Services, P.A. located?

Skin Dermatology And Cosmetic Services, P.A. is located at 865 Saxon Blvd, Orange City, FL 32763. The listed phone number is (386) 256-1969.

What is Skin Dermatology And Cosmetic Services, P.A.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Skin Dermatology And Cosmetic Services, P.A. enrolled in Medicare?

Yes. Skin Dermatology And Cosmetic Services, P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Skin Dermatology And Cosmetic Services, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians reassign their Medicare billing to Skin Dermatology And Cosmetic Services, P.A., in Dermatology, Nurse Practitioner and Plastic and Reconstructive Surgery. 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.

What insurance does Skin Dermatology And Cosmetic Services, P.A. accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare and 1 other insurer list Skin Dermatology And Cosmetic Services, P.A. 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 Skin Dermatology And Cosmetic Services, P.A. was last updated on March 22, 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.