ADVANCED DERMATOLOGY OF MARYLAND PC
NPI 1477388197
Dermatology in La Plata, MD

Active since September 03, 2024CLIA 21D2175030 · Certificate of Compliance
101 CENTENNIAL ST STE H, LA PLATA, MD 20646(301) 292-6010 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Advanced Dermatology Of Maryland Pc NPPES

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

ADVANCED DERMATOLOGY OF MARYLAND PC (NPI 1477388197) is a healthcare organization registered as a dermatology in La Plata, Maryland and active in the NPI registry since September 2024. The organization holds a CLIA Certificate of Compliance certificate valid through March 14, 2028 and lists Matt Louis Leavitt, Owner, as its authorized official.

NPPES Registry Identity

NPI1477388197
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY OF MARYLAND PC
Location Address101 CENTENNIAL ST STE HLa Plata, MD 20646-5976
Mailing Address151 Southhall Ln Ste 300Maitland, FL 32751-7172 · (407) 875-2080
Organization SubpartYes
Authorized OfficialMatt Louis LeavittOwner · (407) 875-2080
Enumeration DateSeptember 3, 2024
NPPES CertifiedSeptember 3, 2024
NPI 1477388197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
101 CENTENNIAL ST STE H, La Plata, MD 20646

Other Identifiers 1

Medicaid8025029MD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 21D2175030

Advanced Dermatology Of Maryland · La Plata, MD
Active · expires Mar 14, 2028
CLIA Number21D2175030
Laboratory TypePhysician Office
Certificate Effective DateMarch 15, 2026
Certificate Expiration DateMarch 14, 2028
Laboratory DirectorDr. Sebastian S. Demarco
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology Of Maryland101 Centennial Street #h, La Plata, MD 20646
CLIA data matches this NPI record on: 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 Advanced Dermatology Of Maryland PC's NPI number?

The NPI number for Advanced Dermatology Of Maryland PC is 1477388197. It was assigned to this organization in the NPPES registry on September 3, 2024.

Where is Advanced Dermatology Of Maryland PC located?

Advanced Dermatology Of Maryland PC is located at 101 Centennial St Ste H, La Plata, MD 20646. The listed phone number is (301) 292-6010.

What is Advanced Dermatology Of Maryland PC's specialty?

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

Does Advanced Dermatology Of Maryland PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 21D2175030) is associated with this NPI, valid through March 14, 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 Advanced Dermatology Of Maryland PC was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.