DERMATOLOGY ASSOCIATES OF ITHACA, LLC
NPI 1609170992
Dermatology in Ithaca, NY
About Dermatology Associates Of Ithaca, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERMATOLOGY ASSOCIATES OF ITHACA, LLC (NPI 1609170992) is a healthcare organization registered as a dermatology in Ithaca, New York and active in the NPI registry since January 2011. The organization holds a CLIA Microscopy certificate valid through March 26, 2027, maintains a secondary practice location in Cortland, and lists Katie Terrazas, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dermatology Associates Of Ithaca, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Dermatology Associates Of Ithaca, LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
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) 33D2112822
Dermatology Associates Of Ithaca · Ithaca, NYFrequently 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 Dermatology Associates Of Ithaca, LLC's NPI number?
The NPI number for Dermatology Associates Of Ithaca, LLC is 1609170992. It was assigned to this organization in the NPPES registry on January 1, 2011.
Where is Dermatology Associates Of Ithaca, LLC located?
Dermatology Associates Of Ithaca, LLC is located at 1051 Craft Rd, Ithaca, NY 14850. The listed phone number is (607) 257-1107.
What is Dermatology Associates Of Ithaca, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Dermatology Associates Of Ithaca, LLC enrolled in Medicare?
Yes. Dermatology Associates Of Ithaca, LLC is registered in the Medicare PECOS enrollment system.
When is Dermatology Associates Of Ithaca, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Dermatology Associates Of Ithaca, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Dermatology Associates Of Ithaca, LLC. 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 Nurse Practitioner (3) and Dermatology (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Dermatology Associates Of Ithaca, LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 33D2112822) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Dermatology Associates Of Ithaca, LLC was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dermatology Associates Of Ithaca, Llc · NPI 1609170992
Dermatology organization in Ithaca, New York. Organization record, active in the CMS NPPES registry since January 1, 2011.
## Identity
- **NPI:** 1609170992 (Entity type: Organization)
- **Enumerated:** January 1, 2011
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Katie Terrazas, OFFICE MANAGER
## Practice location
- **Address:** 1051 CRAFT RD, Ithaca, NY 14850-1016
- **Phone:** (607) 257-1107 · **Fax:** (607) 257-0369
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Dermatology (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 9, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1609170992) · Data from the CMS NPPES public registry.