ADVANCED DERMATOLOGY AT SKINCARE 5TH AVENUE, LLC
NPI 1366277436
Dermatology in Peachtree City, GA

Active since September 06, 2024
2579 HIGHWAY 54, PEACHTREE CITY, GA 30269(770) 487-2645 Get Directions Write a Review

NPPES record last updated: September 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Advanced Dermatology At Skincare 5th Avenue, Llc NPPES

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

ADVANCED DERMATOLOGY AT SKINCARE 5TH AVENUE, LLC (NPI 1366277436) is a healthcare organization registered as a dermatology in Peachtree City, Georgia and active in the NPI registry since September 2024. The organization lists Joseph Galitzin, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366277436
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY AT SKINCARE 5TH AVENUE, LLC
Location Address2579 HIGHWAY 54Peachtree City, GA 30269-1451
Mailing Address2579 Highway 54Peachtree City, GA 30269-1451 · (770) 487-2645
Organization SubpartNo
Authorized OfficialJoseph GalitzinCeo · (707) 487-2645
Enumeration DateSeptember 6, 2024
NPPES CertifiedSeptember 6, 2024
✔ NPI 1366277436 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.
2579 HIGHWAY 54, Peachtree City, GA 30269

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)

Advanced Dermatology At Skincare 5th Avenue, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Advanced Dermatology At Skincare 5th Avenue, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Nurse Practitioner
NPI 1720543218
2579 HIGHWAY 54
Peachtree City, GA 30269
(770) 487-2645
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1184673238
4904 TIMBER RIDGE DR SUITE101
Douglasville, GA 30135
(770) 739-7546
✔ PECOS✔ Accepts Medicare24 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 Advanced Dermatology At Skincare 5th Avenue, LLC's NPI number?

The NPI number for Advanced Dermatology At Skincare 5th Avenue, LLC is 1366277436. It was assigned to this organization in the NPPES registry on September 6, 2024.

Where is Advanced Dermatology At Skincare 5th Avenue, LLC located?

Advanced Dermatology At Skincare 5th Avenue, LLC is located at 2579 Highway 54, Peachtree City, GA 30269. The listed phone number is (770) 487-2645.

What is Advanced Dermatology At Skincare 5th Avenue, LLC's specialty?

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

Is Advanced Dermatology At Skincare 5th Avenue, LLC enrolled in Medicare?

Yes. Advanced Dermatology At Skincare 5th Avenue, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Dermatology At Skincare 5th Avenue, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Advanced Dermatology At Skincare 5th Avenue, LLC, in Dermatology and Nurse Practitioner. 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 at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Advanced Dermatology At Skincare 5th Avenue, LLC was last updated on September 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.