COASTAL DERMATOLOGY PA
NPI 1366431769
Dermatology in Jacksonville, FL
About Coastal Dermatology Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COASTAL DERMATOLOGY PA (NPI 1366431769), doing business as Goyal Dermatology Inc, is a healthcare organization registered as a dermatology in Jacksonville, Florida and active in the NPI registry since October 2005. The organization lists Sanjiva Goyal, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
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)
Coastal Dermatology Pa 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 Coastal Dermatology PA, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Jacksonville, FL 32246
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 Coastal Dermatology PA's NPI number?
The NPI number for Coastal Dermatology PA is 1366431769. It was assigned to this organization in the NPPES registry on October 18, 2005. The provider was formerly known as Goyal Dermatology Inc.
Where is Coastal Dermatology PA located?
Coastal Dermatology PA is located at 2804 Saint Johns Bluff Rd S Ste 109, Jacksonville, FL 32246. The listed phone number is (904) 727-9123.
What is Coastal Dermatology PA's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Coastal Dermatology PA enrolled in Medicare?
Yes. Coastal Dermatology PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Coastal Dermatology PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Coastal Dermatology PA, 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 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Coastal Dermatology PA accept?
Health plans from Ambetter Health, Ambetter of Alabama, AvMed and Molina Healthcare list Coastal Dermatology PA 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 Coastal Dermatology PA was last updated on May 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Coastal Dermatology Pa · NPI 1366431769
Dermatology organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since October 18, 2005.
## Identity
- **NPI:** 1366431769 (Entity type: Organization)
- **Enumerated:** October 18, 2005
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Sanjiva Goyal, PRESIDENT
## Practice location
- **Address:** 2804 SAINT JOHNS BLUFF RD S, STE 109, Jacksonville, FL 32246-3776
- **Phone:** (904) 727-9123 · **Fax:** (904) 855-4255
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (1), Nurse Practitioner (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 8, 2015
- **Other identifiers:** Other 35493Z (FL); Other K3994 (FL); Medicare UPIN G49010 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1366431769) · Data from the CMS NPPES public registry.