FLOWER MOUND DERMATOLOGY
NPI 1407950009
Dermatology in Flower Mound, TX
About Flower Mound Dermatology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FLOWER MOUND DERMATOLOGY (NPI 1407950009) is a healthcare organization registered as a dermatology in Flower Mound, Texas and active in the NPI registry since September 2006. The organization holds a CLIA Microscopy certificate valid through March 12, 2028 and lists Isaac Perez, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Flower Mound Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Flower Mound Dermatology, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 for Provider-Performed Microscopy Procedures (PPMP) 45D1051837
Flower Mound Dermatology,pa · Flower Mound, TXFrequently 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 Flower Mound Dermatology's NPI number?
The NPI number for Flower Mound Dermatology is 1407950009. It was assigned to this organization in the NPPES registry on September 12, 2006.
Where is Flower Mound Dermatology located?
Flower Mound Dermatology is located at 3821 Long Prairie Rd Suite 100, Flower Mound, TX 75028. The listed phone number is (972) 221-2784.
What is Flower Mound Dermatology's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Flower Mound Dermatology enrolled in Medicare?
Yes. Flower Mound Dermatology is registered in the Medicare PECOS enrollment system.
When is Flower Mound Dermatology's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Flower Mound Dermatology?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Flower Mound Dermatology. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Flower Mound Dermatology hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D1051837) is associated with this NPI, valid through March 12, 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 Flower Mound Dermatology was last updated on July 11, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Flower Mound Dermatology · NPI 1407950009
Dermatology organization in Flower Mound, Texas. Organization record, active in the CMS NPPES registry since September 12, 2006.
## Identity
- **NPI:** 1407950009 (Entity type: Organization)
- **Enumerated:** September 12, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Isaac Perez, PRESIDENT
## Practice location
- **Address:** 3821 LONG PRAIRIE RD, SUITE 100, Flower Mound, TX 75028
- **Phone:** (972) 221-2784
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Dermatology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 11, 2007
- **Other identifiers:** Medicare ID-Type Unspecified 00397V (TX); Medicare UPIN G39224 (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1407950009) · Data from the CMS NPPES public registry.