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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALABAMA SKIN CANCER & AESTHETIC CENTER LLC
NPI 1508673773
Dermatology in Vestavia Hills, AL

Active since December 11, 2024CLIA Certified · 3 labs
1360 MONTGOMERY HWY STE 114, VESTAVIA HILLS, AL 35216(205) 379-0900(205) 238-7900 Get Directions Write a Review

NPPES record last updated: September 28, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 28, 2026, Feb 25, 2025, Dec 11, 2024 (3 updates tracked since 2024).

About Alabama Skin Cancer & Aesthetic Center Llc NPPES

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

ALABAMA SKIN CANCER & AESTHETIC CENTER LLC (NPI 1508673773), doing business as Elite Skin, is a healthcare organization registered as a dermatology in Vestavia Hills, Alabama and active in the NPI registry since December 2024. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Daniel J Bergman, Owner, as its authorized official.

NPPES Registry Identity

NPI1508673773
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameALABAMA SKIN CANCER & AESTHETIC CENTER LLC
Location Address1360 MONTGOMERY HWY STE 114Vestavia Hills, AL 35216-2750
Mailing Address1360 Montgomery Hwy Ste 114Vestavia Hills, AL 35216-2750 · (205) 379-0900 · Fax (205) 238-7900
Phone(205) 379-0900
Fax(205) 238-7900
Organization SubpartNo
Authorized OfficialDaniel J BergmanOwner · (205) 379-0900
Enumeration DateDecember 11, 2024
Last NPPES UpdateSeptember 28, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2026
✔ NPI 1508673773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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
1360 MONTGOMERY HWY STE 114, Vestavia Hills, AL 35216
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Other Names 1

Doing Business AsElite Skin

Secondary Practice Locations 2

Location 17201 Copperfield DrMontgomery, AL 36117-7101 · Phone (334) 954-6034 · Fax (205) 238-7900
Location 21600 5th Ave SJasper, AL 35501-4658 · Phone (205) 379-0900 · Fax (205) 238-7900

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alabama Skin Cancer & Aesthetic Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Alabama Skin Cancer & Aesthetic Center LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Daniel Bergman, MD
Dermatology
NPI 1053843169
1360 MONTGOMERY HWY STE 114
Vestavia Hills, AL 35216
(205) 379-0900
✔ PECOS✔ Accepts MedicareSame address
Jo Herzog, MD
Dermatology
NPI 1295828309
1360 MONTGOMERY HWY STE 114
Vestavia Hills, AL 35216
(053) 790-9002
✔ PECOS✔ Accepts MedicareSame address
Angela Spears, CRNP
Nurse Practitioner
NPI 1053956094
1360 MONTGOMERY HWY STE 114
Vestavia Hills, AL 35216
(205) 379-0900
✔ 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.

CLIA Laboratory Certificates CMS CLIA 3

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 01D2349766

Alabama Skin Cancer & Aesthetic Center · Jasper, AL
Active · expires Aug 26, 2028
CLIA Number01D2349766
Laboratory TypePhysician Office
Certificate Effective DateAugust 27, 2026
Certificate Expiration DateAugust 26, 2028
Laboratory DirectorDr. Daniel J. Bergman
Laboratory Phone(205) 379-0900
Laboratory LocationAlabama Skin Cancer & Aesthetic Center1600 5th Ave South, Jasper, AL 35501
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.

Certificate of Compliance 01D2334115

Alabama Skin Cancer & Aesthetic · Montgomery, AL
Active · expires Jul 21, 2028
CLIA Number01D2334115
Laboratory TypePhysician Office
Certificate Effective DateJuly 22, 2026
Certificate Expiration DateJuly 21, 2028
Laboratory DirectorDaniel J. Bergman
Laboratory Phone(205) 379-0900
Laboratory LocationAlabama Skin Cancer & Aesthetic7201 Copperfield Drive, Montgomery, AL 36117
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.

Certificate of Compliance 01D2316463

Alabama Skin Cancer & Aesthetic Center · Vestavia Hills, AL
Active · expires Nov 20, 2027
CLIA Number01D2316463
Laboratory TypePhysician Office
Certificate Effective DateNovember 21, 2025
Certificate Expiration DateNovember 20, 2027
Laboratory DirectorDaniel J. Bergman
Laboratory Phone(205) 379-0900
Laboratory LocationAlabama Skin Cancer & Aesthetic Center1360 Montgomery Highway Ste 114, Vestavia Hills, AL 35216
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 Alabama Skin Cancer & Aesthetic Center LLC's NPI number?

The NPI number for Alabama Skin Cancer & Aesthetic Center LLC is 1508673773. It was assigned to this organization in the NPPES registry on December 11, 2024. The provider is doing business as Elite Skin.

Where is Alabama Skin Cancer & Aesthetic Center LLC located?

Alabama Skin Cancer & Aesthetic Center LLC is located at 1360 Montgomery Hwy Ste 114, Vestavia Hills, AL 35216. The listed phone number is (205) 379-0900.

What is Alabama Skin Cancer & Aesthetic Center LLC's specialty?

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

Is Alabama Skin Cancer & Aesthetic Center LLC enrolled in Medicare?

Yes. Alabama Skin Cancer & Aesthetic Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Alabama Skin Cancer & Aesthetic Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Alabama Skin Cancer & Aesthetic Center LLC, in Dermatology and Nurse Practitioner. 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, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Alabama Skin Cancer & Aesthetic Center LLC hold CLIA laboratory certificates?

Yes. 3 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 Alabama Skin Cancer & Aesthetic Center LLC was last updated on September 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.