PARK AVENUE DERMATOLOGY PA
NPI 1205871001
Dermatology in Orange Park, FL
About Park Avenue Dermatology Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PARK AVENUE DERMATOLOGY PA (NPI 1205871001) is a healthcare organization registered as a dermatology in Orange Park, Florida and active in the NPI registry since June 2006. The organization holds 2 active CLIA laboratory certificates and lists George J Schmieder, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted 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)
Park Avenue Dermatology Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Park Avenue Dermatology PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 10D1029474
Park Avenue Dermatology PA · Orange Park, FLCertificate of Compliance 10D2101438
Park Avenue Dermatology North · Jacksonville, FLFrequently 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 Park Avenue Dermatology PA's NPI number?
The NPI number for Park Avenue Dermatology PA is 1205871001. It was assigned to this organization in the NPPES registry on June 17, 2006.
Where is Park Avenue Dermatology PA located?
Park Avenue Dermatology PA is located at 906 Park Ave, Orange Park, FL 32073. The listed phone number is (904) 541-0315.
What is Park Avenue Dermatology PA's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Park Avenue Dermatology PA enrolled in Medicare?
Yes. Park Avenue Dermatology PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Park Avenue Dermatology PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Dermatology, reassign their Medicare billing to Park Avenue Dermatology PA. 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, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Park Avenue Dermatology PA 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 Park Avenue Dermatology PA accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Park Avenue Dermatology PA 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 Park Avenue Dermatology PA was last updated on December 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Park Avenue Dermatology Pa · NPI 1205871001
Dermatology organization in Orange Park, Florida. Organization record, active in the CMS NPPES registry since June 17, 2006.
## Identity
- **NPI:** 1205871001 (Entity type: Organization)
- **Enumerated:** June 17, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** George Schmieder, PRESIDENT
## Practice location
- **Address:** 906 PARK AVE, Orange Park, FL 32073-4120
- **Phone:** (904) 541-0315 · **Fax:** (904) 541-0316
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 13, 2023
- **CLIA laboratory certificates:** 2 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1205871001) · Data from the CMS NPPES public registry.