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WAKE DERMATOLOGY ASSOCIATES, PA
NPI 1497815328
Dermatology in Raleigh, NC

Active since December 11, 2006
4414 LAKE BOONE TRL, STE 408, RALEIGH, NC 27607(919) 781-1001(919) 781-3909 Get Directions Write a Review

NPPES record last updated: April 4, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Wake Dermatology Associates, Pa NPPES

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

WAKE DERMATOLOGY ASSOCIATES, PA (NPI 1497815328) is a healthcare organization registered as a dermatology in Raleigh, North Carolina and active in the NPI registry since December 2006. The organization lists Adnan Nasir, Physician, Owner, as its authorized official.

NPPES Registry Identity

NPI1497815328
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWAKE DERMATOLOGY ASSOCIATES, PA
Location Address4414 LAKE BOONE TRL, STE 408Raleigh, NC 27607-7513
Mailing Address4414 Lake Boone Trl, Ste 408Raleigh, NC 27607-7513 · (919) 781-1001 · Fax (919) 781-3909
Phone(919) 781-1001
Fax(919) 781-3909
Organization SubpartNo
Authorized OfficialAdnan NasirPhysician, Owner · (919) 781-1001
Enumeration DateDecember 11, 2006
Last NPPES UpdateApril 4, 2011
✔ NPI 1497815328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NC · 40537
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 · Procedural DermatologyTaxonomy 207NS0135X · License 40537 (NC)
4414 LAKE BOONE TRL, Raleigh, NC 27607
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Other Identifiers 4

Medicare PIN2264790
Other2344640Medicare Group Number
Other02261NC · Blue Cross Group Number
Medicare PIN2029252

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 MULTIPLE 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)

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

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Wake Dermatology Associates, PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jessica Kirk, MD
Dermatology
NPI 1649470493
4414 LAKE BOONE TRL SUITE 408
Raleigh, NC 27607
(919) 781-1001
✔ PECOS✔ Accepts MedicareSame address
Adnan Nasir, M.D.
Dermatology
NPI 1457429706
4414 LAKE BOONE TRL WAKE DERMATOLOGY, SUITE 408
Raleigh, NC 27607
(919) 781-1001
✔ PECOS✔ Accepts MedicareSame address

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 Wake Dermatology Associates, PA's NPI number?

The NPI number for Wake Dermatology Associates, PA is 1497815328. It was assigned to this organization in the NPPES registry on December 11, 2006.

Where is Wake Dermatology Associates, PA located?

Wake Dermatology Associates, PA is located at 4414 Lake Boone Trl Ste 408, Raleigh, NC 27607. The listed phone number is (919) 781-1001.

What is Wake Dermatology Associates, PA's specialty?

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

Is Wake Dermatology Associates, PA enrolled in Medicare?

Yes. Wake Dermatology Associates, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wake Dermatology Associates, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Wake Dermatology Associates, PA. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Wake Dermatology Associates, PA was last updated on April 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.