SKIN MD
NPI 1255851200
Dermatology - MOHS-Micrographic Surgery in Lexington, KY

Q: What is Regional Dermatology PLLC's NPI number?

The NPI number for Regional Dermatology PLLC is 1255851200. It was assigned to this organization in the NPPES registry on June 21, 2017. The provider is doing business as Skin MD and SkinMD.

Q: What is Regional Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Active since June 21, 2017CLIA 18D2136302 · Certificate of Compliance

989 GOVERNORS LN STE 220, LEXINGTON, KY 40513(859) 296-7546(859) 721-0829 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Oct 30, 2019, Jun 16, 2018 and 2 more (5 updates tracked since 2017).

On this page

About Skin Md NPPES

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

SKIN MD (NPI 1255851200) is a healthcare organization registered as a mohs-micrographic surgery in Lexington, Kentucky and active in the NPI registry since June 2017. The organization holds a CLIA Certificate of Compliance certificate valid through December 7, 2027 and lists Samuel J Pruden, President, as its authorized official.

NPPES Registry Identity

NPI1255851200

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameREGIONAL DERMATOLOGY PLLC

Location Address989 GOVERNORS LN STE 220Lexington, KY 40513-1175

Mailing Address989 Governors Ln Ste 220Lexington, KY 40513-1175 · (859) 296-7546 · Fax (859) 721-0829

Phone(859) 296-7546

Fax(859) 721-0829

Organization SubpartNo

Authorized OfficialSamuel J PrudenPresident · (859) 296-7546

Enumeration DateJune 21, 2017

Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration

✔ NPI 1255851200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in KY · 34192

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X · License 34192 (KY)

Also ListedOtolaryngologyTaxonomy 207Y00000X · License 34192 (KY)

Also ListedPlastic SurgeryTaxonomy 208200000X · License 34192 (KY)

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X

989 GOVERNORS LN STE 220, Lexington, KY 40513

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Other Names 2

Doing Business AsSkin Md

Doing Business AsSkinmd

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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 Md 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 Skin MD, which bills Medicare for the services this clinician delivers.

Clinician (1)

Samuel Pruden, MD

Dermatology

NPI 1871593996

989 GOVERNORS LN STE 260
Lexington, KY 40513

(859) 296-7546

✔ 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

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 18D2136302

Regional Dermatology · Lexington, KY

Active · expires Dec 7, 2027

CLIA Number18D2136302

Laboratory TypePhysician Office

Certificate Effective DateDecember 8, 2025

Certificate Expiration DateDecember 7, 2027

Laboratory DirectorDr. Samuel Pruden

Laboratory Phone(859) 296-7546

Laboratory LocationRegional Dermatology989 Governors Ln Suite 260, Lexington, KY 40513

CLIA data matches this NPI record on: 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.

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 Regional Dermatology PLLC's NPI number?

The NPI number for Regional Dermatology PLLC is 1255851200. It was assigned to this organization in the NPPES registry on June 21, 2017. The provider is doing business as Skin MD and SkinMD.

Where is Regional Dermatology PLLC located?

Regional Dermatology PLLC is located at 989 Governors Ln Ste 220, Lexington, KY 40513. The listed phone number is (859) 296-7546.

What is Regional Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Regional Dermatology PLLC enrolled in Medicare?

Yes. Regional Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Regional Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Regional Dermatology PLLC. 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 Regional Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 18D2136302) is associated with this NPI, valid through December 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Regional Dermatology PLLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Regional Dermatology PLLC 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 Regional Dermatology PLLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.