EAST BAY DERMATOLOGY MEDICAL GROUP INC
NPI 1447220215
Dermatology in Fremont, CA
About East Bay Dermatology Medical Group Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST BAY DERMATOLOGY MEDICAL GROUP INC (NPI 1447220215), doing business as Center For Dermatology Cosmetic & Laser Surgery, is a healthcare organization registered as a dermatology in Fremont, California and active in the NPI registry since January 2006. The organization holds a CLIA Certificate of Compliance certificate valid through August 15, 2028 and lists Sunil S Dhawan, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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)
East Bay Dermatology Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
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
6Medicare enrollment records show 6 clinicians reassign Medicare billing to East Bay Dermatology Medical Group Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
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 05D0598729
East Bay Dermatology Medical Group, Inc · Fremont, CAFrequently 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 East Bay Dermatology Medical Group Inc's NPI number?
The NPI number for East Bay Dermatology Medical Group Inc is 1447220215. It was assigned to this organization in the NPPES registry on January 25, 2006. The provider is doing business as Center for Dermatology Cosmetic & Laser Surgery.
Where is East Bay Dermatology Medical Group Inc located?
East Bay Dermatology Medical Group Inc is located at 2557 Mowry Ave Ste 25, Fremont, CA 94538. The listed phone number is (510) 797-4111.
What is East Bay Dermatology Medical Group Inc's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is East Bay Dermatology Medical Group Inc enrolled in Medicare?
Yes. East Bay Dermatology Medical Group Inc is registered in the Medicare PECOS enrollment system.
When is East Bay Dermatology Medical Group Inc'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 (California, Clinic/Group Practice) is due for revalidation by November 30, 2026. 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 East Bay Dermatology Medical Group Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians reassign their Medicare billing to East Bay Dermatology Medical Group Inc, in Dermatology, Micrographic Dermatologic Surgery (MDS) 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, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does East Bay Dermatology Medical Group Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 05D0598729) is associated with this NPI, valid through August 15, 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 East Bay Dermatology Medical Group Inc was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# East Bay Dermatology Medical Group Inc · NPI 1447220215
Dermatology organization in Fremont, California. Organization record, active in the CMS NPPES registry since January 25, 2006.
## Identity
- **NPI:** 1447220215 (Entity type: Organization)
- **Enumerated:** January 25, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Also known as:** Center for Dermatology Cosmetic & Laser Surgery (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Sunil Dhawan, OWNER
## Practice location
- **Address:** 2557 MOWRY AVE STE 25, Fremont, CA 94538-1614
- **Phone:** (510) 797-4111 · **Fax:** (510) 797-3320
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 6 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (2), Micrographic Dermatologic Surgery (MDS) (2), Nurse Practitioner (2); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 15, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1447220215) · Data from the CMS NPPES public registry.