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SKIN GROUP PLLC
NPI 1366564494
Dermatology - MOHS-Micrographic Surgery in Louisville, KY

Active since April 06, 2007CLIA Certified · 2 labs
2307 RIVER RD STE 101, LOUISVILLE, KY 40206(502) 583-6647(502) 585-4824 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 9, 2024, Feb 18, 2020 (2 updates tracked since 2020).

About Skin Group Pllc NPPES

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

SKIN GROUP PLLC (NPI 1366564494) is a healthcare organization registered as a mohs-micrographic surgery in Louisville, Kentucky and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Shepherdsville, and lists Robert H Zax, President, as its authorized official.

NPPES Registry Identity

NPI1366564494
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameSKIN GROUP PLLC
Location Address2307 RIVER RD STE 101Louisville, KY 40206-5000
Mailing AddressPo Box 36422Louisville, KY 40233-6422 · (502) 583-6647
Phone(502) 583-6647
Fax(502) 585-4824
Organization SubpartNo
Authorized OfficialRobert H ZaxPresident · (502) 583-6647
Enumeration DateApril 6, 2007
Last NPPES UpdateOctober 9, 20242 updates tracked since enumeration
NPPES CertifiedOctober 9, 2024
✔ NPI 1366564494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in KY · 25359
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 ListedPhysician AssistantTaxonomy 363A00000X · License PA1034 (KY)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 4440P (KY)
2307 RIVER RD STE 101, Louisville, KY 40206
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Secondary Practice Location 1

Location 11868 W Hebron Ln Ste 200Shepherdsville, KY 40165-7481 · Phone (502) 583-6647 · Fax (502) 585-4824

Other Identifiers 4

Medicaid78904968KY
Other18D0934789KY · Clia Number
Medicaid65938797KY
OtherDA0326KY · Rr Mcr

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 Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.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 Group Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Skin Group PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Robert Zax, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1689659781
2307 RIVER RD STE 101
Louisville, KY 40206
(502) 583-6647
✔ PECOS✔ Accepts MedicareSame address
Brittany Boylan, APRN
Nurse Practitioner
NPI 1073877635
2307 RIVER RD STE 101
Louisville, KY 40206
(502) 583-6647
✔ PECOS✔ Accepts MedicareSame address
Michelle Hannigan, APRN
Nurse Practitioner
NPI 1518983188
4938 BROWNSBORO RD STE 206
Louisville, KY 40222
(502) 339-2922
✔ PECOS✔ Accepts Medicare4.3 mi
Shannon England, APRN
Nurse Practitioner
NPI 1851665038
13802 LAKE POINT CIR #102
Louisville, KY 40223
(502) 245-4450
✔ PECOS11 mi

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 2

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 18D2031658

Skin Group PLLC, The · Shepherdsville, KY
Active · expires Feb 1, 2028
CLIA Number18D2031658
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorDr. Robert H. Zax
Laboratory Phone(502) 583-6647
Laboratory LocationSkin Group PLLC, The1868 W Hebron Lane, Suite 200, Shepherdsville, KY 40165
CLIA data matches this NPI record on: Address 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.

Certificate of Compliance 18D0934789

Skin Group PLLC, The · Louisville, KY
Active · expires Jan 13, 2028
CLIA Number18D0934789
Laboratory TypePhysician Office
Certificate Effective DateJanuary 14, 2026
Certificate Expiration DateJanuary 13, 2028
Laboratory DirectorDr. Robert H. Zax
Laboratory Phone(502) 583-6647
Laboratory LocationSkin Group PLLC, The2307 River Rd, Ste101, Louisville, KY 40206
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 Skin Group PLLC's NPI number?

The NPI number for Skin Group PLLC is 1366564494. It was assigned to this organization in the NPPES registry on April 6, 2007.

Where is Skin Group PLLC located?

Skin Group PLLC is located at 2307 River Rd Ste 101, Louisville, KY 40206. The listed phone number is (502) 583-6647.

What is Skin Group PLLC's specialty?

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

Is Skin Group PLLC enrolled in Medicare?

Yes. Skin Group PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Skin Group PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Skin Group 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. The largest specialties are Nurse Practitioner (3) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Skin Group PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Skin Group PLLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Skin Group 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 Skin Group PLLC was last updated on October 9, 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.