PALM HARBOR DERMATOLOGY PA
NPI 1497927016
Dermatology in Palm Harbor, FL

Active since March 25, 2008CLIA 10D1081226 · Certificate of Compliance
4197 WOODLANDS PKWY, PALM HARBOR, FL 34685(727) 786-3810(727) 786-3855 Get Directions Write a Review

NPPES record last updated: February 28, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 28, 2025, Jul 27, 2021 (2 updates tracked since 2021).

About Palm Harbor Dermatology Pa NPPES

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

PALM HARBOR DERMATOLOGY PA (NPI 1497927016), doing business as Phdermatology, is a healthcare organization registered as a dermatology in Palm Harbor, Florida and active in the NPI registry since March 2008. The organization holds a CLIA Certificate of Compliance certificate valid through August 10, 2028 and lists Amy Simon Ross, Ceo, as its authorized official.

NPPES Registry Identity

NPI1497927016
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePALM HARBOR DERMATOLOGY PA
Location Address4197 WOODLANDS PKWYPalm Harbor, FL 34685-3493
Mailing Address4197 Woodlands PkwyPalm Harbor, FL 34685-3493 · (813) 333-1512 · Fax (813) 333-1561
Fax(727) 786-3855
Organization SubpartNo
Authorized OfficialAmy Simon RossCeo · (813) 333-1512
Enumeration DateMarch 25, 2008
Last NPPES UpdateFebruary 28, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 28, 2025
✔ NPI 1497927016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedPathology · DermatopathologyTaxonomy 207ZD0900X
4197 WOODLANDS PKWY, Palm Harbor, FL 34685

Other Names 1

Doing Business AsPhdermatology

Other Identifiers 1

Other000WRFL · Florida Blue

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

23

Medicare enrollment records show 23 clinicians reassign Medicare billing to Palm Harbor Dermatology PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 7 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Dermatology16
Nurse Practitioner6
Plastic and Reconstructive Surgery1

Nearest to this location (20)

See all 23
Nurse Practitioner
NPI 1366394124
4197 WOODLANDS PKWY
Palm Harbor, FL 34685
(727) 786-3810
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1619359320
4197 WOODLANDS PKWY
Palm Harbor, FL 34685
(727) 786-3810
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1184606816
1840 MEASE DR SUITE 406
Safety Harbor, FL 34695
(727) 712-8222
✔ PECOS✔ Accepts Medicare1.8 mi
Dermatology
NPI 1972064574
1840 MEASE DR STE 406
Safety Harbor, FL 34695
(727) 712-8222
✔ PECOS✔ Accepts Medicare1.8 mi
Dermatology
NPI 1154940690
11601 SHELDON RD
Tampa, FL 33626
(813) 324-6630
✔ PECOS✔ Accepts Medicare7.6 mi
Nurse Practitioner
NPI 1962870204
11601 SHELDON RD
Tampa, FL 33626
(813) 324-6630
✔ PECOS✔ Accepts Medicare7.6 mi
Dermatology
NPI 1700816162
11601 SHELDON RD
Tampa, FL 33626
(813) 324-6630
✔ PECOS✔ Accepts Medicare7.6 mi
Nurse Practitioner
NPI 1205547999
3622 MADACA LN
Tampa, FL 33618
(813) 513-3643
✔ PECOS✔ Accepts Medicare13 mi
Dermatology
NPI 1316912082
3622 MADACA LN
Tampa, FL 33618
(813) 513-3643
✔ PECOS✔ Accepts Medicare13 mi
Dermatology
NPI 1003441254
15416 N FLORIDA AVE
Tampa, FL 33613
(813) 960-2400
✔ PECOS✔ Accepts Medicare15 mi
Dermatology
NPI 1013317460
310 S. MACDILL AVE. SUITE 201
Tampa, FL 33609
(813) 609-3810
✔ PECOS✔ Accepts Medicare16 mi
Dermatology
NPI 1740817162
1425 S HOWARD AVE
Tampa, FL 33606
(813) 253-2635
✔ PECOS✔ Accepts Medicare17 mi
Nurse Practitioner
NPI 1578059606
1425 S HOWARD AVE
Tampa, FL 33606
(813) 253-2635
✔ PECOS✔ Accepts Medicare17 mi
Dermatology
NPI 1609840487
1425 S HOWARD AVE
Tampa, FL 33606
(813) 253-2635
✔ PECOS✔ Accepts Medicare17 mi
Dermatology
NPI 1659564193
1425 S HOWARD AVE
Tampa, FL 33606
(813) 253-2635
✔ PECOS✔ Accepts Medicare17 mi
Plastic and Reconstructive Surgery
NPI 1346508421
1000 W KENNEDY BLVD # 202
Tampa, FL 33606
(813) 434-3238
✔ PECOS✔ Accepts Medicare17 mi
Dermatology
NPI 1285374421
17 DAVIS BLVD STE 308
Tampa, FL 33606
(813) 974-2201
✔ PECOS17 mi
Dermatology
NPI 1922685791
13321 N 56TH ST
Tampa, FL 33617
(813) 341-1488
✔ PECOS✔ Accepts Medicare19 mi
Dermatology
NPI 1801424098
621 MEDICAL CARE DR
Brandon, FL 33511
(813) 657-3330
✔ PECOS✔ Accepts Medicare27 mi
Nurse Practitioner
NPI 1942824594
621 MEDICAL CARE DR
Brandon, FL 33511
(813) 657-3330
✔ PECOS✔ Accepts Medicare27 mi
See all 23 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 10D1081226

Palm Harbor Dermatology · Palm Harbor, FL
Active · expires Aug 10, 2028
CLIA Number10D1081226
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2026
Certificate Expiration DateAugust 10, 2028
Laboratory DirectorDr. Amy S. Ross
Laboratory Phone(727) 786-3810
Laboratory LocationPalm Harbor Dermatology4197 Woodlands Pkwy, Palm Harbor, FL 34685
CLIA data matches this NPI record on: Address 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 Palm Harbor Dermatology PA's NPI number?

The NPI number for Palm Harbor Dermatology PA is 1497927016. It was assigned to this organization in the NPPES registry on March 25, 2008. The provider is doing business as PHDermatology.

Where is Palm Harbor Dermatology PA located?

Palm Harbor Dermatology PA is located at 4197 Woodlands Pkwy, Palm Harbor, FL 34685. The listed phone number is (727) 786-3810.

What is Palm Harbor Dermatology PA's specialty?

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

Is Palm Harbor Dermatology PA enrolled in Medicare?

Yes. Palm Harbor Dermatology PA is registered in the Medicare PECOS enrollment system.

Does Palm Harbor Dermatology PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D1081226) is associated with this NPI, valid through August 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Palm Harbor Dermatology PA accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Palm Harbor Dermatology PA 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 Palm Harbor Dermatology PA was last updated on February 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.