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FINGER LAKES DERMATOLOGY PLLC
NPI 1508402710
Dermatology in Freeville, NY

Active since November 22, 2019CLIA 33D2177830 · Microscopy
2141 DRYDEN RD, FREEVILLE, NY 13068(607) 708-1330(607) 708-4242 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 13, 2022, Mar 24, 2021, Jan 28, 2020 and 2 more (5 updates tracked since 2019).

About Finger Lakes Dermatology Pllc NPPES

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

FINGER LAKES DERMATOLOGY PLLC (NPI 1508402710) is a healthcare organization registered as a dermatology in Freeville, New York and active in the NPI registry since November 2019. The organization holds a CLIA Microscopy certificate valid through December 1, 2026 and lists Brad Yentzer, Owner, as its authorized official.

NPPES Registry Identity

NPI1508402710
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameFINGER LAKES DERMATOLOGY PLLC
Location Address2141 DRYDEN RDFreeville, NY 13068
Mailing Address2141 Dryden RoadFreeville, NY 13068-9611 · (607) 708-1330
Phone(607) 708-1330
Fax(607) 708-4242
Organization SubpartNo
Authorized OfficialBrad YentzerOwner · (607) 708-1330
Enumeration DateNovember 22, 2019
Last NPPES UpdateApril 13, 20225 updates tracked since enumeration
NPPES CertifiedApril 13, 2022
✔ NPI 1508402710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
2141 DRYDEN RD, Freeville, NY 13068
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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)

Finger Lakes Dermatology Pllc 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 Finger Lakes Dermatology PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Brad Yentzer, MD
Dermatology
NPI 1962677138
2141 DRYDEN RD
Freeville, NY 13068
(607) 708-1330
✔ PECOS✔ Accepts Medicare0.5 mi
Kimberly Silvers, MD
Dermatology
NPI 1275508533
200 MADISON AVE STE 1D
Elmira, NY 14901
(607) 873-1832
✔ PECOS✔ Accepts Medicare36 mi

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 for Provider-Performed Microscopy Procedures (PPMP) 33D2177830

Finger Lakes Dermatology PLLC · Freeville, NY
Active · expires Dec 1, 2026
CLIA Number33D2177830
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2024
Certificate Expiration DateDecember 1, 2026
Laboratory DirectorDr. Brad A. Yentzer
Laboratory Phone(607) 708-1330
Laboratory LocationFinger Lakes Dermatology PLLC2141 Dryden Road, Freeville, NY 13068
CLIA data matches this NPI record on: Address 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.

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 Finger Lakes Dermatology PLLC's NPI number?

The NPI number for Finger Lakes Dermatology PLLC is 1508402710. It was assigned to this organization in the NPPES registry on November 22, 2019.

Where is Finger Lakes Dermatology PLLC located?

Finger Lakes Dermatology PLLC is located at 2141 Dryden Rd, Freeville, NY 13068. The listed phone number is (607) 708-1330.

What is Finger Lakes Dermatology PLLC's specialty?

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

Is Finger Lakes Dermatology PLLC enrolled in Medicare?

Yes. Finger Lakes Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Finger Lakes Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Finger Lakes Dermatology PLLC. 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, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Finger Lakes Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 33D2177830) is associated with this NPI, valid through December 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Finger Lakes Dermatology PLLC was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.