PRESTIGE DERMATOLOGY OF ALLIANCE, PLLC
NPI 1427415314
Dermatology in Fort Worth, TX
About Prestige Dermatology Of Alliance, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRESTIGE DERMATOLOGY OF ALLIANCE, PLLC (NPI 1427415314) is a healthcare organization registered as a dermatology in Fort Worth, Texas and active in the NPI registry since January 2016. The organization lists Ryan Pham, Managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted 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)
Prestige Dermatology Of Alliance, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Prestige Dermatology Of Alliance, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
Fort Worth, TX 76137
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Prestige Dermatology Of Alliance, PLLC's NPI number?
The NPI number for Prestige Dermatology Of Alliance, PLLC is 1427415314. It was assigned to this organization in the NPPES registry on January 22, 2016.
Where is Prestige Dermatology Of Alliance, PLLC located?
Prestige Dermatology Of Alliance, PLLC is located at 3629 Western Center Blvd Suite 201, Fort Worth, TX 76137. The listed phone number is (817) 766-7421.
What is Prestige Dermatology Of Alliance, PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Prestige Dermatology Of Alliance, PLLC enrolled in Medicare?
Yes. Prestige Dermatology Of Alliance, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prestige Dermatology Of Alliance, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Prestige Dermatology Of Alliance, PLLC, in Dermatology, Family Practice 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Prestige Dermatology Of Alliance, PLLC accept?
Health plans from Molina Healthcare list Prestige Dermatology Of Alliance, 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 Prestige Dermatology Of Alliance, PLLC was last updated on January 21, 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.
# Prestige Dermatology Of Alliance, Pllc · NPI 1427415314
Dermatology organization in Fort Worth, Texas. Organization record, active in the CMS NPPES registry since January 22, 2016.
## Identity
- **NPI:** 1427415314 (Entity type: Organization)
- **Enumerated:** January 22, 2016
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Ryan Pham, MANAGING MEMBER
## Practice location
- **Address:** 3629 WESTERN CENTER BLVD, SUITE 201, Fort Worth, TX 76137-1939
- **Phone:** (817) 766-7421
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (2), Nurse Practitioner (2), Family Practice (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 21, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1427415314) · Data from the CMS NPPES public registry.