ATLANTIC DERMATOLOGY LLC
NPI 1306957378
Dermatology - Procedural Dermatology in Cocoa Beach, FL

Q: What is Atlantic Dermatology LLC's NPI number?

The NPI number for Atlantic Dermatology LLC is 1306957378. It was assigned to this organization in the NPPES registry on August 31, 2006.

Q: What is Atlantic Dermatology LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Active since August 31, 2006

1980 N ATLANTIC AVE, SUITE 722, COCOA BEACH, FL 32931(321) 784-8811(321) 799-4424 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

On this page

About Atlantic Dermatology Llc NPPES

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

ATLANTIC DERMATOLOGY LLC (NPI 1306957378) is a healthcare organization registered as a procedural dermatology in Cocoa Beach, Florida and active in the NPI registry since August 2006. The organization lists Kristin Widick Smallwood, President, as its authorized official.

NPPES Registry Identity

NPI1306957378

Entity TypeOrganization

Primary Taxonomy207NS0135X

Legal Business NameATLANTIC DERMATOLOGY LLC

Location Address1980 N ATLANTIC AVE, SUITE 722Cocoa Beach, FL 32931-5213

Mailing Address1980 N Atlantic Ave, Suite 722Cocoa Beach, FL 32931-5213 · (321) 784-8811 · Fax (321) 799-4424

Phone(321) 784-8811

Fax(321) 799-4424

Organization SubpartNo

Authorized OfficialKristin Widick SmallwoodPresident · (321) 784-8811

Enumeration DateAugust 31, 2006

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1306957378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Also ListedDermatologyTaxonomy 207N00000X

Also ListedDermatology · Clinical & Laboratory Dermatological ImmunologyTaxonomy 207NI0002X

Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X

1980 N ATLANTIC AVE, Cocoa Beach, FL 32931

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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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinician (1)

Kristin Smallwood, M.D.

Dermatology

NPI 1346350352

1980 N ATLANTIC AVE SUITE 722
Cocoa Beach, FL 32931

(321) 784-8811

✔ 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.

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 Atlantic Dermatology LLC's NPI number?

The NPI number for Atlantic Dermatology LLC is 1306957378. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Atlantic Dermatology LLC located?

Atlantic Dermatology LLC is located at 1980 N Atlantic Ave Suite 722, Cocoa Beach, FL 32931. The listed phone number is (321) 784-8811.

What is Atlantic Dermatology LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Atlantic Dermatology LLC enrolled in Medicare?

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

How many clinicians bill Medicare through Atlantic Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Atlantic 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 Atlantic Dermatology LLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.