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ADVANCED DERMATOLOGY AND COSMETIC SUR
NPI 1487812947
Dermatology in Boca Raton, FL

Active since May 30, 2008CLIA 10D0867664 · Certificate of Compliance
1905 CLINT MOORE RD, SUITE 103, BOCA RATON, FL 33496(561) 241-4474(561) 241-9667 Get Directions Write a Review

NPPES record last updated: December 4, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Advanced Dermatology And Cosmetic Sur NPPES

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

ADVANCED DERMATOLOGY AND COSMETIC SUR (NPI 1487812947) is a healthcare organization registered as a dermatology in Boca Raton, Florida and active in the NPI registry since May 2008. The organization holds a CLIA Certificate of Compliance certificate valid through January 23, 2027 and lists Amy Declue, Director, Provider Services, as its authorized official.

NPPES Registry Identity

NPI1487812947
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLEAVITT MEDICAL ASSOCIATES OF FLORIDA INC
Location Address1905 CLINT MOORE RD, SUITE 103Boca Raton, FL 33496-2658
Mailing Address151 Southhall Ln, Ste 300Maitland, FL 32751-7176 · (407) 875-2080 · Fax (407) 650-3455
Phone(561) 241-4474
Fax(561) 241-9667
Organization SubpartYes
Authorized OfficialAmy DeclueDirector, Provider Services · (407) 875-2080
Enumeration DateMay 30, 2008
Last NPPES UpdateDecember 4, 2014
✔ NPI 1487812947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPlastic SurgeryTaxonomy 208200000X
1905 CLINT MOORE RD, Boca Raton, FL 33496
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Other Names 1

Doing Business AsAdvanced Dermatology And Cosmetic Sur

Other Identifiers 1

Medicare PIN98046BFL

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.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)

Advanced Dermatology And Cosmetic Sur is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

115

Medicare enrollment records show 115 clinicians reassign Medicare billing to Advanced Dermatology And Cosmetic Sur, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Dermatology63
Nurse Practitioner35
Plastic and Reconstructive Surgery8
Pathology5
Micrographic Dermatologic Surgery (MDS)2
Otolaryngology1
Physician Assistant1

Nearest to this location (20)

See all 115
Patricia Klem, D.O.
Dermatology
NPI 1164626545
1905 CLINT MOORE RD. STE. 103 ADVANCED DERMATOLOGY
Boca Raton, FL 33496
(561) 241-5858
✔ PECOS✔ Accepts MedicareSame address
Liliana Montoya, M.D.
Dermatology
NPI 1669861407
1905 CLINT MOORE RD STE 103
Boca Raton, FL 33496
(866) 400-3376
✔ PECOS✔ Accepts MedicareSame address
Robin Burger
Pathology
NPI 1588058648
1300 NW 17TH AVE STE 130
Delray Beach, FL 33445
(561) 819-0857
✔ PECOS✔ Accepts Medicare5.3 mi
Shuo Liu, MD; PHD
Pathology
NPI 1336644590
1300 NW 17TH AVE
Delray Beach, FL 33445
(773) 816-4522
✔ PECOS✔ Accepts Medicare5.3 mi
Etan Marks, D.O.
Pathology
NPI 1528301728
1300 NW 17TH AVE STE 130A
Delray Beach, FL 33445
(866) 400-3376
✔ PECOS✔ Accepts Medicare5.3 mi
Martin Schiff, MD
Dermatology
NPI 1659336832
3000 UNIVERSITY DR STE K
Coral Springs, FL 33065
(954) 752-2630
✔ PECOS✔ Accepts Medicare12 mi
Apphia Wang, MD
Dermatology
NPI 1902224553
1035 S STATE ROAD 7 STE 122
Wellington, FL 33414
(650) 353-6377
✔ PECOS✔ Accepts Medicare23 mi
Scott Podnos, MD
Dermatology
NPI 1053421446
290 INDIAN TRCE
Weston, FL 33326
(954) 908-3604
✔ PECOS✔ Accepts Medicare26 mi
Chava Lustig, DO
Dermatology
NPI 1326158866
290 INDIAN TRCE
Weston, FL 33326
(954) 908-3604
✔ PECOS✔ Accepts Medicare26 mi
Ashley Pardue Gomez, RN
Nurse Practitioner
NPI 1851705735
4060 SHERIDAN ST STE C
Hollywood, FL 33021
(954) 987-7512
✔ PECOS26 mi
Danielle Dubin, MD
Dermatology
NPI 1285256305
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare28 mi
Mark Kaufmann, M.D.
Dermatology
NPI 1386648616
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare28 mi
Annyella Douglas
Dermatology
NPI 1619438348
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare28 mi
Nicky Gazy
Dermatology
NPI 1104311075
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare28 mi
Jay Gottlieb, DO
Dermatology
NPI 1588660757
3 SW 129TH AVE STE 100
Pembroke Pines, FL 33027
(866) 400-3376
✔ PECOS✔ Accepts Medicare28 mi
Raymond Ramirez, DO
Dermatology
NPI 1063614840
600 VILLAGE SQUARE XING
Palm Beach Gardens, FL 33410
(561) 693-0540
✔ PECOS✔ Accepts Medicare30 mi
William Mcdonald, MD
Plastic and Reconstructive Surgery
NPI 1356307979
8740 N KENDALL DR STE 101
Miami, FL 33176
(305) 381-8900
✔ PECOS✔ Accepts Medicare54 mi
Mary Collins
Nurse Practitioner
NPI 1588537583
3755 7TH TER STE 101
Vero Beach, FL 32960
(772) 569-5056
✔ PECOS✔ Accepts Medicare88 mi
Edmundo Barreto, APRN
Nurse Practitioner
NPI 1346909421
615 WILLIAMS AVE
Lehigh Acres, FL 33972
(239) 310-5269
✔ PECOS✔ Accepts Medicare95 mi
Evdakiya Deiner, APRN
Nurse Practitioner
NPI 1457755795
484 US HIGHWAY 1 STE C
Sebastian, FL 32958
(772) 646-6100
✔ PECOS✔ Accepts Medicare98 mi
See all 115 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

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 10D0867664

Advanced Dermatology And Cosmetic Surgery · Boca Raton, FL
Active · expires Jan 23, 2027
CLIA Number10D0867664
Laboratory TypePhysician Office
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorDr. Scott Podnos
Laboratory Phone(407) 284-3407
Laboratory LocationAdvanced Dermatology And Cosmetic Surgery1905 Clint Moore Road Ste 103, Boca Raton, FL 33496
CLIA data matches this NPI record on: Address 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 Leavitt Medical Associates Of Florida Inc's NPI number?

The NPI number for Leavitt Medical Associates Of Florida Inc is 1487812947. It was assigned to this organization in the NPPES registry on May 30, 2008. The provider is doing business as Advanced Dermatology And Cosmetic Sur.

Where is Leavitt Medical Associates Of Florida Inc located?

Leavitt Medical Associates Of Florida Inc is located at 1905 Clint Moore Rd Suite 103, Boca Raton, FL 33496. The listed phone number is (561) 241-4474.

What is Leavitt Medical Associates Of Florida Inc's specialty?

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

Is Leavitt Medical Associates Of Florida Inc enrolled in Medicare?

Yes. Leavitt Medical Associates Of Florida Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Leavitt Medical Associates Of Florida Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 115 clinicians in 7 Medicare specialties reassign their Medicare billing to Leavitt Medical Associates Of Florida Inc. 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 (63), Nurse Practitioner (35) and Plastic and Reconstructive Surgery (8). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Leavitt Medical Associates Of Florida Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D0867664) is associated with this NPI, valid through January 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Leavitt Medical Associates Of Florida Inc accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Leavitt Medical Associates Of Florida Inc 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 Leavitt Medical Associates Of Florida Inc was last updated on December 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.