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NEW PRESTON DERMATOLOGY, LLC
NPI 1407430655
Dermatology in New Preston, CT

Active since May 12, 2021CLIA 07D2235992 · Certificate of Compliance
18 E SHORE RD, NEW PRESTON, CT 06777(484) 868-9998(860) 393-1079 Get Directions Write a Review

NPPES record last updated: June 24, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 24, 2021, May 12, 2021 (2 updates tracked since 2021).

About New Preston Dermatology, Llc NPPES

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

NEW PRESTON DERMATOLOGY, LLC (NPI 1407430655) is a healthcare organization registered as a dermatology in New Preston, Connecticut and active in the NPI registry since May 2021. The organization holds a CLIA Certificate of Compliance certificate valid through May 19, 2028 and lists Andreas Boker, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1407430655
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNEW PRESTON DERMATOLOGY, LLC
Location Address18 E SHORE RDNew Preston, CT 06777-1628
Mailing Address18 E Shore RdNew Preston, CT 06777-1628 · (484) 868-9998
Phone(484) 868-9998
Fax(860) 393-1079
Organization SubpartNo
Authorized OfficialAndreas BokerMedical Director · (917) 902-0540
Enumeration DateMay 12, 2021
Last NPPES UpdateJune 24, 20212 updates tracked since enumeration
NPPES CertifiedJune 24, 2021
✔ NPI 1407430655 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.
18 E SHORE RD, New Preston, CT 06777
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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)

New Preston Dermatology, 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 New Preston Dermatology, 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)

Brent Wainwright, MD
Dermatology
NPI 1598737462
18 E SHORE RD
New Preston, CT 06777
(484) 868-9998
✔ PECOS✔ Accepts MedicareSame address
Andreas Boker, M.D
Dermatology
NPI 1306972120
75 SPRING ST FL 2
New York, NY 10012
(212) 431-4749
✔ PECOS✔ Accepts Medicare74 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 07D2235992

New Preston Dermatology · New Preston, CT
Active · expires May 19, 2028
CLIA Number07D2235992
Laboratory TypePhysician Office
Certificate Effective DateMay 20, 2026
Certificate Expiration DateMay 19, 2028
Laboratory DirectorAndreas Boker
Laboratory Phone(860) 339-6606
Laboratory LocationNew Preston Dermatology18 E Shore Rd, New Preston, CT 06777
CLIA data matches this NPI record on: Address Name
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 New Preston Dermatology, LLC's NPI number?

The NPI number for New Preston Dermatology, LLC is 1407430655. It was assigned to this organization in the NPPES registry on May 12, 2021.

Where is New Preston Dermatology, LLC located?

New Preston Dermatology, LLC is located at 18 E Shore Rd, New Preston, CT 06777. The listed phone number is (484) 868-9998.

What is New Preston Dermatology, LLC's specialty?

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

Is New Preston Dermatology, LLC enrolled in Medicare?

Yes. New Preston Dermatology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through New Preston Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to New Preston Dermatology, LLC. 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.

Does New Preston Dermatology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 07D2235992) is associated with this NPI, valid through May 19, 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 New Preston Dermatology, LLC was last updated on June 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.