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SUNRISE DERMATOLOGY
NPI 1477708642
Dermatology - MOHS-Micrographic Surgery in Vestavia Hls, AL

Active since December 01, 2008CLIA Certified · 10 labs
1940 STONEGATE DR STE 130, VESTAVIA HLS, AL 35242(205) 977-9876(205) 977-9976 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 25, 2024, Sep 2, 2020, Aug 8, 2018 (3 updates tracked since 2018).

About Sunrise Dermatology NPPES

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

SUNRISE DERMATOLOGY (NPI 1477708642) is a healthcare organization registered as a mohs-micrographic surgery in Vestavia Hls, Alabama and active in the NPI registry since December 2008. The organization holds 10 active CLIA laboratory certificates and lists Karen Lake, Administration, as its authorized official.

NPPES Registry Identity

NPI1477708642
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameAQUA DERMATOLOGY OF ALABAMA PC
Location Address1940 STONEGATE DR STE 130Vestavia Hls, AL 35242
Mailing Address1940 Stonegate Dr Ste 130Vestavia Hls, AL 35242-2541 · (205) 977-9876 · Fax (205) 977-9976
Phone(205) 977-9876
Fax(205) 977-9976
Organization SubpartNo
Authorized OfficialKaren LakeAdministration · (205) 977-9786
Enumeration DateDecember 1, 2008
Last NPPES UpdateJune 25, 20243 updates tracked since enumeration
NPPES CertifiedJune 25, 2024
✔ NPI 1477708642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in AL · 20579
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X · License 20579 (AL)
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License 20579 (AL)
1940 STONEGATE DR STE 130, Vestavia Hls, AL 35242
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Other Names 3

Doing Business AsSunrise Dermatology
Doing Business AsSurgical Dermatology Group
Doing Business AsTrue Dermatology

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)

Sunrise Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

46

Medicare enrollment records show 46 clinicians reassign Medicare billing to Sunrise Dermatology, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 12 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Dermatology23
Nurse Practitioner19
Micrographic Dermatologic Surgery (MDS)2
Emergency Medicine1
Pathology1

Nearest to this location (20)

See all 46
Jessie Blackmon, CRNP
Nurse Practitioner
NPI 1811460173
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Christopher Harmon, MD
Dermatology
NPI 1497791628
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Thomas Harrison
Dermatology
NPI 1346702289
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Christopher Heath, DO, MPAS
Dermatology
NPI 1477845097
1940 STONEGATE DR STE 140
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Wasim Haidari, MD
Dermatology
NPI 1376172056
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOSSame address
Brian King, M.D.
Dermatology
NPI 1407274756
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
James Maddox
Nurse Practitioner
NPI 1013475508
1940 STONEGATE DR
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Kevin Kwan, MD
Dermatology
NPI 1922502764
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Terra Nelson, NP
Nurse Practitioner
NPI 1952433328
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts MedicareSame address
Jonathan Cappel, MD
Dermatology
NPI 1174819049
1940 STONEGATE DR STE 130
Vestavia Hls, AL 35242
(205) 977-9876
✔ PECOS✔ Accepts Medicare0.1 mi
Rachel Pflederer, MD
Dermatology
NPI 1598184566
2900 CAHABA RD
Mountain Brk, AL 35223
(205) 877-9773
✔ PECOS✔ Accepts Medicare4.1 mi
Daniel Bergman, MD
Dermatology
NPI 1053843169
1360 MONTGOMERY HWY STE 114
Vestavia Hills, AL 35216
(205) 379-0900
✔ PECOS✔ Accepts Medicare6.6 mi
Leighann Clanton, RN CRNP
Nurse Practitioner
NPI 1366612046
6285 PARK SOUTH DRIVE
Bessemer, AL 35022
(205) 426-5507
✔ PECOS✔ Accepts Medicare16 mi
Anne Love, FNP-C
Nurse Practitioner
NPI 1649749797
615 1ST ST N
Alabaster, AL 35007
(205) 624-2100
✔ PECOS✔ Accepts Medicare17 mi
Raj Patel
Micrographic Dermatologic Surgery (MDS)
NPI 1720379712
615 1ST ST N SUITE317
Alabaster, AL 35007
(205) 592-5135
✔ PECOS✔ Accepts Medicare17 mi
Nilam Patel, M.D.
Emergency Medicine
NPI 1275610602
5000 MEDICAL WEST WAY
Bessemer, AL 35022
(205) 481-7000
✔ PECOS✔ Accepts Medicare19 mi
Maria Mihailescu, MD
Dermatology
NPI 1326629635
1440 JONES DAIRY RD
Jasper, AL 35501
(205) 977-9876
✔ PECOS✔ Accepts Medicare40 mi
Paige Mcdonald, CRNP
Nurse Practitioner
NPI 1528004264
1890 AL HIGHWAY 157 SUITE 300
Cullman, AL 35058
(256) 737-8000
✔ PECOS✔ Accepts Medicare50 mi
Leia Hunt, CRNP, FNP-BC
Nurse Practitioner
NPI 1366781460
1300 BRIDGE CREEK DR. NE
Cullman, AL 35055
(256) 737-7546
✔ PECOS✔ Accepts Medicare50 mi
Vernon Forrester, MD
Dermatology
NPI 1679002729
104 J E BRISCOE WAY
Madison, AL 35758
(256) 705-3000
✔ PECOS✔ Accepts Medicare85 mi
See all 46 clinicians

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 10

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) 01D2347442

Aqua Dermatology Of Alabama, PC Dba Surgical Dermatology · Decatur, AL
Active · expires Jul 16, 2028
CLIA Number01D2347442
Laboratory TypePhysician Office
Certificate Effective DateJuly 17, 2026
Certificate Expiration DateJuly 16, 2028
Laboratory DirectorJon Cappel
Laboratory Phone(205) 977-9876
Laboratory LocationAqua Dermatology Of Alabama, PC Dba Surgical Dermatology802 Bank Street NE, Decatur, AL 35601
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 01D2347448

Aqua Dermatology Of Alabama, PC Dba Surgical Dermatology · Alexander City, AL
Active · expires Jul 16, 2028
CLIA Number01D2347448
Laboratory TypePhysician Office
Certificate Effective DateJuly 17, 2026
Certificate Expiration DateJuly 16, 2028
Laboratory DirectorBrian King
Laboratory Phone(205) 977-9876
Laboratory LocationAqua Dermatology Of Alabama, PC Dba Surgical Dermatology3368 Us 280 Suite 200, Alexander City, AL 35010
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 01D2347451

Aqua Dermatology Of Alabama, PC Dba Surgical Dermatology · Gadsden, AL
Active · expires Jul 16, 2028
CLIA Number01D2347451
Laboratory TypePhysician Office
Certificate Effective DateJuly 17, 2026
Certificate Expiration DateJuly 16, 2028
Laboratory DirectorBrian King
Laboratory Phone(205) 977-9876
Laboratory LocationAqua Dermatology Of Alabama, PC Dba Surgical Dermatology407 South 4th Street, Gadsden, AL 35901
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 01D2345097

Aqua Dermatology Of Alabama, PC Dba Surgical Dermatology Group · Jasper, AL
Active · expires Jun 3, 2028
CLIA Number01D2345097
Laboratory TypePhysician Office
Certificate Effective DateJune 4, 2026
Certificate Expiration DateJune 3, 2028
Laboratory DirectorDr. Brian King
Laboratory Phone(205) 977-9876
Laboratory LocationAqua Dermatology Of Alabama, PC Dba Surgical Dermatology Group1440 Jones Diary Road, Jasper, AL 35501
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 01D2033028

Aqua Dermatology Of Alabama PC Surgical Dermatology Group - Oxford · Oxford, AL
Active · expires May 31, 2028
CLIA Number01D2033028
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2026
Certificate Expiration DateMay 31, 2028
Laboratory DirectorJonathan A. Cappel
Laboratory Phone(205) 977-9876
Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Group - Oxford1419 Hamric Drive East Suite 202, Oxford, AL 36203
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 01D1016733

Aqua Dermatology Of Alabama PC Surgical Dermatology Group - Huntsville · Huntsville, AL
Active · expires Apr 13, 2028
CLIA Number01D1016733
Laboratory TypePhysician Office
Certificate Effective DateApril 14, 2026
Certificate Expiration DateApril 13, 2028
Laboratory DirectorDr. Christopher B. Harmon
Laboratory Phone(205) 977-9876
Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Group - Huntsville4810 Whitesport Circle SW Suite 110, Huntsville, AL 35801
CLIA data matches this NPI record on: Name Phone
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 Aqua Dermatology Of Alabama PC's NPI number?

The NPI number for Aqua Dermatology Of Alabama PC is 1477708642. It was assigned to this organization in the NPPES registry on December 1, 2008. The provider is doing business as Sunrise Dermatology, Surgical Dermatology Group and True Dermatology.

Where is Aqua Dermatology Of Alabama PC located?

Aqua Dermatology Of Alabama PC is located at 1940 Stonegate Dr Ste 130, Vestavia Hls, AL 35242. The listed phone number is (205) 977-9876.

What is Aqua Dermatology Of Alabama PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Aqua Dermatology Of Alabama PC enrolled in Medicare?

Yes. Aqua Dermatology Of Alabama PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Aqua Dermatology Of Alabama PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 46 clinicians in 5 Medicare specialties reassign their Medicare billing to Aqua Dermatology Of Alabama PC. 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. The largest specialties are Dermatology (23), Nurse Practitioner (19) and Micrographic Dermatologic Surgery (MDS) (2). Of these, 9 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Aqua Dermatology Of Alabama PC hold CLIA laboratory certificates?

Yes. 10 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Aqua Dermatology Of Alabama PC was last updated on June 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.