ADVANCE DERMATOLOGY & LASER MEDICAL CENTER INC.
NPI 1396849576
Dermatology - Procedural Dermatology in Marina Del Rey, CA

Q: What is Advance Dermatology & Laser Medical Center Inc.'s specialty?

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

Active since September 11, 2006CLIA 05D0939439 · Certificate of Compliance

4560 ADMIRALTY WAY STE 101, MARINA DEL REY, CA 90292(310) 577-7544(310) 577-5255 Get Directions Write a Review

NPPES record last updated: December 16, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 16, 2022, Aug 22, 2020 (2 updates tracked since 2020).

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About Advance Dermatology & Laser Medical Center Inc. NPPES

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

ADVANCE DERMATOLOGY & LASER MEDICAL CENTER INC. (NPI 1396849576) is a healthcare organization registered as a procedural dermatology in Marina Del Rey, California and active in the NPI registry since September 2006. The organization holds a CLIA Certificate of Compliance certificate valid through April 14, 2027 and lists Nita Paryus Patel, Owner, as its authorized official.

NPPES Registry Identity

NPI1396849576

Entity TypeOrganization

Primary Taxonomy207NS0135X

Legal Business NameADVANCE DERMATOLOGY & LASER MEDICAL CENTER INC.

Location Address4560 ADMIRALTY WAY STE 101Marina Del Rey, CA 90292-5424

Mailing Address4560 Admiralty Way Ste 101Marina Del Rey, CA 90292-5424 · (310) 577-7544 · Fax (310) 577-5255

Phone(310) 577-7544

Fax(310) 577-5255

Organization SubpartNo

Authorized OfficialNita Paryus PatelOwner · (310) 577-7544

Enumeration DateSeptember 11, 2006

Last NPPES UpdateDecember 16, 20222 updates tracked since enumeration

NPPES CertifiedDecember 16, 2022

✔ NPI 1396849576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

License✔ Licensed in CA · G076981

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).

4560 ADMIRALTY WAY STE 101, Marina Del Rey, CA 90292

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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)

Advance Dermatology & Laser Medical Center Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Advance Dermatology & Laser Medical Center Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Nita Patel, M.D.

Dermatology

NPI 1295786663

4560 ADMIRALTY WAY SUITE 101
Marina Del Rey, CA 90292

(310) 577-7544

✔ PECOS✔ Accepts MedicareSame address

Sarah Storniolo, NURSE PRACTITIONER

Nurse Practitioner

NPI 1215554068

8631 W 3RD ST STE 1035
Los Angeles, CA 90048

(310) 659-9075

✔ PECOS✔ Accepts Medicare7.2 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

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 05D0939439

Advance Dermatology & Laser · Marina Del Rey, CA

Active · expires Apr 14, 2027

CLIA Number05D0939439

Laboratory TypePhysician Office

Certificate Effective DateApril 15, 2025

Certificate Expiration DateApril 14, 2027

Laboratory DirectorNita Patel MD

Laboratory Phone(310) 577-7544

Laboratory LocationAdvance Dermatology & Laser4560 Admiralty Way, Ste 101, Marina Del Rey, CA 90292

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.

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 Advance Dermatology & Laser Medical Center Inc.'s NPI number?

The NPI number for Advance Dermatology & Laser Medical Center Inc. is 1396849576. It was assigned to this organization in the NPPES registry on September 11, 2006.

Where is Advance Dermatology & Laser Medical Center Inc. located?

Advance Dermatology & Laser Medical Center Inc. is located at 4560 Admiralty Way Ste 101, Marina Del Rey, CA 90292. The listed phone number is (310) 577-7544.

What is Advance Dermatology & Laser Medical Center Inc.'s specialty?

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

Is Advance Dermatology & Laser Medical Center Inc. enrolled in Medicare?

Yes. Advance Dermatology & Laser Medical Center Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advance Dermatology & Laser Medical Center Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Advance Dermatology & Laser Medical Center Inc., 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 and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advance Dermatology & Laser Medical Center Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0939439) is associated with this NPI, valid through April 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advance Dermatology & Laser Medical Center Inc. was last updated on December 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.