LUMEN DERMATOLOGY LLC
NPI 1235938341
Dermatology in Lady Lake, FL

Active since March 11, 2025
781 HIGHWAY 466, LADY LAKE, FL 32159(352) 830-1500(352) 830-1501 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 29, 2026, Mar 16, 2025 (2 updates tracked since 2025).

About Lumen Dermatology Llc NPPES

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

LUMEN DERMATOLOGY LLC (NPI 1235938341) is a healthcare organization registered as a dermatology in Lady Lake, Florida and active in the NPI registry since March 2025. The organization lists David J Kosiorek, President, as its authorized official.

NPPES Registry Identity

NPI1235938341
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLUMEN DERMATOLOGY LLC
Location Address781 HIGHWAY 466Lady Lake, FL 32159-6340
Mailing Address4365 Se 15th AveOcala, FL 34480-6613 · (352) 830-1500 · Fax (352) 830-1501
Fax(352) 830-1501
Organization SubpartNo
Authorized OfficialDavid J KosiorekPresident · (813) 598-9837
Enumeration DateMarch 11, 2025
Last NPPES UpdateJuly 29, 20262 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1235938341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
781 HIGHWAY 466, Lady Lake, FL 32159

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinician (1)

Dermatology
NPI 1629174941
14310 N DALE MABRY HWY STE 180
Tampa, FL 33618
(813) 962-4210
✔ PECOS✔ Accepts Medicare68 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 Lumen Dermatology LLC's NPI number?

The NPI number for Lumen Dermatology LLC is 1235938341. It was assigned to this organization in the NPPES registry on March 11, 2025.

Where is Lumen Dermatology LLC located?

Lumen Dermatology LLC is located at 781 Highway 466, Lady Lake, FL 32159. The listed phone number is (352) 830-1500.

What is Lumen Dermatology LLC's specialty?

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

Is Lumen Dermatology LLC enrolled in Medicare?

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

How many clinicians bill Medicare through Lumen Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Lumen 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.

When was this NPI record last updated?

The NPPES record for Lumen Dermatology LLC was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.