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PROSYNERGY DERMATOLOGY LLC
NPI 1205518875
Dermatology in Martinez, GA

Active since August 03, 2023CLIA Certified · 2 labs
111 DAVIS RD, MARTINEZ, GA 30907(706) 432-9285(706) 432-9674 Get Directions Write a Review

NPPES record last updated: August 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Prosynergy Dermatology Llc NPPES

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

PROSYNERGY DERMATOLOGY LLC (NPI 1205518875) is a healthcare organization registered as a dermatology in Martinez, Georgia and active in the NPI registry since August 2023. The organization holds 2 active CLIA laboratory certificates and lists Stephen Melvin Squires, Ceo And President, as its authorized official.

NPPES Registry Identity

NPI1205518875
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePROSYNERGY DERMATOLOGY LLC
Location Address111 DAVIS RDMartinez, GA 30907-2383
Mailing Address111 Davis RdMartinez, GA 30907-2383 · (706) 432-9285 · Fax (706) 432-9674
Phone(706) 432-9285
Fax(706) 432-9674
Organization SubpartNo
Authorized OfficialStephen Melvin SquiresCeo And President · (706) 432-9285
Enumeration DateAugust 3, 2023
NPPES CertifiedAugust 3, 2023
✔ NPI 1205518875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
111 DAVIS RD, Martinez, GA 30907
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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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.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)

Prosynergy Dermatology 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 Prosynergy Dermatology LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stephen Squires, M.D.
Dermatology
NPI 1346476199
111 DAVIS RD
Martinez, GA 30907
(706) 432-9285
✔ 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 2

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 11D2288803

Prosynergy Dermatology LLC Ld Phone (801) 368-5460 · Martinez, GA
Active · expires Jul 1, 2027
CLIA Number11D2288803
Laboratory TypePhysician Office
Certificate Effective DateJuly 2, 2025
Certificate Expiration DateJuly 1, 2027
Laboratory DirectorStephen M. Squires
Laboratory Phone(706) 432-9285
Laboratory LocationProsynergy Dermatology LLC Ld Phone (801) 368-5460111 Davis Road, Martinez, GA 30907
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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D2297674

Prosynergy Dermatology LLC · North Augusta, SC
Active · expires Jan 18, 2028
CLIA Number42D2297674
Laboratory TypePhysician Office
Certificate Effective DateJanuary 19, 2026
Certificate Expiration DateJanuary 18, 2028
Laboratory DirectorStephen M. Squires
Laboratory Phone(706) 432-9285
Laboratory LocationProsynergy Dermatology LLC440 W Martintown Road, North Augusta, SC 29841
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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 Prosynergy Dermatology LLC's NPI number?

The NPI number for Prosynergy Dermatology LLC is 1205518875. It was assigned to this organization in the NPPES registry on August 3, 2023.

Where is Prosynergy Dermatology LLC located?

Prosynergy Dermatology LLC is located at 111 Davis Rd, Martinez, GA 30907. The listed phone number is (706) 432-9285.

What is Prosynergy Dermatology LLC's specialty?

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

Is Prosynergy Dermatology LLC enrolled in Medicare?

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

How many clinicians bill Medicare through Prosynergy Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Prosynergy Dermatology 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 Prosynergy Dermatology LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Prosynergy Dermatology LLC accept?

Health plans from BlueCross BlueShield of South Carolina list Prosynergy Dermatology 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 Prosynergy Dermatology LLC was last updated on August 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.