EASTERN CONNECTICUT DERMATOLOGY
NPI 1265868558
Dermatology in Groton, CT
About Eastern Connecticut Dermatology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EASTERN CONNECTICUT DERMATOLOGY (NPI 1265868558) is a healthcare organization registered as a dermatology in Groton, Connecticut and active in the NPI registry since September 2013. The organization holds a CLIA Microscopy certificate valid through February 9, 2028 and lists Jeffrey D. Queen, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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)
Eastern Connecticut Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Eastern Connecticut Dermatology, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 for Provider-Performed Microscopy Procedures (PPMP) 07D0095280
Integrated Dermatology Of Groton · Groton, CTFrequently 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 Integrated Dermatology Of Groton LLC's NPI number?
The NPI number for Integrated Dermatology Of Groton LLC is 1265868558. It was assigned to this organization in the NPPES registry on September 19, 2013. The provider is doing business as Eastern Connecticut Dermatology.
Where is Integrated Dermatology Of Groton LLC located?
Integrated Dermatology Of Groton LLC is located at 481 Gold Star Hwy Ste 201, Groton, CT 06340. The listed phone number is (860) 445-8020.
What is Integrated Dermatology Of Groton LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Integrated Dermatology Of Groton LLC enrolled in Medicare?
Yes. Integrated Dermatology Of Groton LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Integrated Dermatology Of Groton LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Integrated Dermatology Of Groton 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Integrated Dermatology Of Groton LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 07D0095280) is associated with this NPI, valid through February 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Integrated Dermatology Of Groton LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Integrated Dermatology Of Groton 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 Integrated Dermatology Of Groton LLC was last updated on January 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Eastern Connecticut Dermatology · NPI 1265868558
Dermatology organization in Groton, Connecticut. Organization record, active in the CMS NPPES registry since September 19, 2013.
## Identity
- **NPI:** 1265868558 (Entity type: Organization)
- **Enumerated:** September 19, 2013
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Legal business name:** Integrated Dermatology Of Groton Llc
- **Organization subpart:** No
- **Authorized official:** Jeffrey Queen, MANAGER
## Practice location
- **Address:** 481 GOLD STAR HWY STE 201, Groton, CT 06340-6702
- **Phone:** (860) 445-8020
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 11, 2019
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1265868558) · Data from the CMS NPPES public registry.