DERMATOLOGY ASSOCIATES LLC
NPI 1235318874
Clinic/Center - Medical Specialty in Jackson, MS
About Dermatology Associates Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERMATOLOGY ASSOCIATES LLC (NPI 1235318874) is a healthcare organization registered as a medical specialty in Jackson, Mississippi and active in the NPI registry since October 2007. The organization holds a CLIA Certificate of Compliance certificate valid through April 20, 2027 and lists Sabra Sullivan, Manager/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dermatology Associates Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Dermatology Associates LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 25D0993428
Dermatology Associates LLC · Jackson, MSFrequently 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 Dermatology Associates LLC's NPI number?
The NPI number for Dermatology Associates LLC is 1235318874. It was assigned to this organization in the NPPES registry on October 31, 2007.
Where is Dermatology Associates LLC located?
Dermatology Associates LLC is located at 501 Marshall St Ste 606, Jackson, MS 39202. The listed phone number is (601) 355-8555.
What is Dermatology Associates LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.
Is Dermatology Associates LLC enrolled in Medicare?
Yes. Dermatology Associates LLC is registered in the Medicare PECOS enrollment system.
When is Dermatology Associates LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Dermatology Associates LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Dermatology Associates 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 Dermatology Associates LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 25D0993428) is associated with this NPI, valid through April 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Dermatology Associates LLC was last updated on October 31, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Dermatology Associates Llc · NPI 1235318874
Medical Specialty organization in Jackson, Mississippi. Organization record, active in the CMS NPPES registry since October 31, 2007.
## Identity
- **NPI:** 1235318874 (Entity type: Organization)
- **Enumerated:** October 31, 2007
- **Primary specialty:** Clinic/Center - Medical Specialty · taxonomy 261QM2500X
- **Organization subpart:** No
- **Authorized official:** Sabra Sullivan, MANAGER/OWNER
## Practice location
- **Address:** 501 MARSHALL ST STE 606, Jackson, MS 39202-1650
- **Phone:** (601) 355-8555 · **Fax:** (601) 355-2244
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Dermatology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 31, 2007
- **Other identifiers:** Medicare PIN CO2663 (MS)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1235318874) · Data from the CMS NPPES public registry.