ADVANCED DERMATOLOGY OF MARYLAND PC
NPI 1386479004
Dermatology in Fort Washington, MD
About Advanced Dermatology Of Maryland Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADVANCED DERMATOLOGY OF MARYLAND PC (NPI 1386479004) is a healthcare organization registered as a dermatology in Fort Washington, Maryland and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through July 22, 2028 and lists Matt Louis Leavitt, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Group Practice 1
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 Of Maryland Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
14Medicare enrollment records show 14 clinicians reassign Medicare billing to Advanced Dermatology Of Maryland PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (14)
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 of Waiver 21D1105196
Advanced Dermatology Of Maryland · Fort Washington, MDFrequently 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 Of Maryland PC's NPI number?
The NPI number for Advanced Dermatology Of Maryland PC is 1386479004. It was assigned to this organization in the NPPES registry on September 3, 2024.
Where is Advanced Dermatology Of Maryland PC located?
Advanced Dermatology Of Maryland PC is located at 11701 Livingston Rd Ste 302, Fort Washington, MD 20744. The listed phone number is (301) 292-6010.
What is Advanced Dermatology Of Maryland PC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Advanced Dermatology Of Maryland PC enrolled in Medicare?
Yes. Advanced Dermatology Of Maryland PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Advanced Dermatology Of Maryland PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 5 Medicare specialties reassign their Medicare billing to Advanced Dermatology Of Maryland PC. 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 Dermatology (10), Diagnostic Radiology (1) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Advanced Dermatology Of Maryland PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D1105196) is associated with this NPI, valid through July 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Advanced Dermatology Of Maryland PC was last updated on September 3, 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.