RENEWAL DERMATOLOGY & MEDSPA, P.C.
NPI 1619232469
Dermatology in Gainesville, VA
About Renewal Dermatology & Medspa, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RENEWAL DERMATOLOGY & MEDSPA, P.C. (NPI 1619232469) is a healthcare organization registered as a dermatology in Gainesville, Virginia and active in the NPI registry since July 2012. The organization holds 8 active CLIA laboratory certificates and lists Kurt L Maggio, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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)
Renewal Dermatology & Medspa, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 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.
Clinicians Billing Medicare Through This Organization
17Medicare enrollment records show 17 clinicians reassign Medicare billing to Renewal Dermatology & Medspa, P.C., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (17)
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 8
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 Accreditation 49D2034129
Renewal Dermatology And Medspa · Gainesville, VACertificate of Waiver 49D2174454
Renewal Dermatology + Medspa · Gainesville, VACertificate of Waiver 49D2171177
Renewal Dermatology & Medspa · Manassas, VACertificate of Waiver 49D2171183
Renewal Dermatology & Medspa · Fairfax, VACertificate of Waiver 49D2171085
Renewal Dermatology & Medspa · Manassas, VACertificate of Compliance 49D2165185
Renewal Dermatology + Medspa · Springfield, VAFrequently 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 Renewal Dermatology & Medspa, P.C.'s NPI number?
The NPI number for Renewal Dermatology & Medspa, P.C. is 1619232469. It was assigned to this organization in the NPPES registry on July 9, 2012.
Where is Renewal Dermatology & Medspa, P.C. located?
Renewal Dermatology & Medspa, P.C. is located at 7512 Gardner Park Dr, Gainesville, VA 20155. The listed phone number is (703) 753-9860.
What is Renewal Dermatology & Medspa, P.C.'s specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Renewal Dermatology & Medspa, P.C. enrolled in Medicare?
Yes. Renewal Dermatology & Medspa, P.C. is registered in the Medicare PECOS enrollment system.
When is Renewal Dermatology & Medspa, P.C.'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 (District of Columbia, Clinic/Group Practice) is due for revalidation by January 31, 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 Renewal Dermatology & Medspa, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 3 Medicare specialties reassign their Medicare billing to Renewal Dermatology & Medspa, P.C.. 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 Dermatology (14), Nurse Practitioner (2) and Internal Medicine (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Renewal Dermatology & Medspa, P.C. hold CLIA laboratory certificates?
Yes. 8 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 Renewal Dermatology & Medspa, P.C. was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Renewal Dermatology & Medspa, P.c. · NPI 1619232469
Dermatology organization in Gainesville, Virginia. Organization record, active in the CMS NPPES registry since July 9, 2012.
## Identity
- **NPI:** 1619232469 (Entity type: Organization)
- **Enumerated:** July 9, 2012
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Kurt Maggio, PRESIDENT
## Practice location
- **Address:** 7512 GARDNER PARK DR, Gainesville, VA 20155-3414
- **Phone:** (703) 753-9860 · **Fax:** (703) 753-9863
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, District of Columbia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 17 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (14), Nurse Practitioner (2), Internal Medicine (1); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 9, 2025
- **CLIA laboratory certificates:** 8 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619232469) · Data from the CMS NPPES public registry.