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SACRED HEART DERMATOLOGY
NPI 1609536267
Dermatology in Mooresville, NC

Active since December 23, 2021
170 MEDICAL PARK RD STE 203, MOORESVILLE, NC 28117(980) 550-2400(950) 550-2424 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 30, 2021, Dec 23, 2021 (2 updates tracked since 2021).

About Sacred Heart Dermatology NPPES

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

SACRED HEART DERMATOLOGY (NPI 1609536267) is a healthcare organization registered as a dermatology in Mooresville, North Carolina and active in the NPI registry since December 2021. The organization lists Blake Sanders, Founder & Medical Director, as its authorized official.

NPPES Registry Identity

NPI1609536267
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSANDERS MEDICAL GROUP, PLLC
Location Address170 MEDICAL PARK RD STE 203Mooresville, NC 28117-8540
Mailing Address170 Medical Park Rd Ste 203Mooresville, NC 28117-8540 · (980) 550-2400 · Fax (950) 550-2424
Phone(980) 550-2400
Fax(950) 550-2424
Organization SubpartNo
Authorized OfficialBlake SandersFounder & Medical Director · (980) 550-2400
Enumeration DateDecember 23, 2021
Last NPPES UpdateDecember 30, 20212 updates tracked since enumeration
NPPES CertifiedDecember 30, 2021
✔ NPI 1609536267 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.
170 MEDICAL PARK RD STE 203, Mooresville, NC 28117
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Other Names 1

Doing Business AsSacred Heart Dermatology

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, Cigna Healthcare.Insurance ›

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)

Sacred Heart Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

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.

StateEnrollment IDDue date
StateNorth CarolinaEnrollment IDO20220207000666Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sacred Heart Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Blake Sanders, DO
Dermatology
NPI 1972962710
170 MEDICAL PARK RD STE 203
Mooresville, NC 28117
(980) 550-2400
✔ 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 Sanders Medical Group, PLLC's NPI number?

The NPI number for Sanders Medical Group, PLLC is 1609536267. It was assigned to this organization in the NPPES registry on December 23, 2021. The provider is doing business as Sacred Heart Dermatology.

Where is Sanders Medical Group, PLLC located?

Sanders Medical Group, PLLC is located at 170 Medical Park Rd Ste 203, Mooresville, NC 28117. The listed phone number is (980) 550-2400.

What is Sanders Medical Group, PLLC's specialty?

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

Is Sanders Medical Group, PLLC enrolled in Medicare?

Yes. Sanders Medical Group, PLLC is registered in the Medicare PECOS enrollment system.

When is Sanders Medical Group, PLLC'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 (North Carolina, Clinic/Group Practice) is due for revalidation by February 28, 2027. 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 Sanders Medical Group, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Sanders Medical Group, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Sanders Medical Group, PLLC accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and Cigna Healthcare list Sanders Medical Group, PLLC 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 Sanders Medical Group, PLLC was last updated on December 30, 2021. 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.