AESTHETIC DERMATOLOGY & COSMETIC SURGERY MEDICAL ASSOCIATES, INC
NPI 1639162480
Dermatology in Mill Valley, CA

Active since August 26, 2005
535 MILLER AVE, MILL VALLEY, CA 94941(415) 383-5486(415) 389-7455 Get Directions Write a Review

NPPES record last updated: December 16, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 16, 2022, Jul 29, 2020 (2 updates tracked since 2020).

About Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc NPPES

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

AESTHETIC DERMATOLOGY & COSMETIC SURGERY MEDICAL ASSOCIATES, INC (NPI 1639162480) is a healthcare organization registered as a dermatology in Mill Valley, California and active in the NPI registry since August 2005. The organization lists Michelle Lanoue, Remote Business Supervisor, as its authorized official.

NPPES Registry Identity

NPI1639162480
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameAESTHETIC DERMATOLOGY & COSMETIC SURGERY MEDICAL ASSOCIATES, INC
Location Address535 MILLER AVEMill Valley, CA 94941-2905
Mailing Address535 Miller AveMill Valley, CA 94941-2905 · (415) 383-5486 · Fax (415) 389-7455
Fax(415) 389-7455
Organization SubpartNo
Authorized OfficialMichelle LanoueRemote Business Supervisor · (605) 484-7519
Enumeration DateAugust 26, 2005
Last NPPES UpdateDecember 16, 20222 updates tracked since enumeration
NPPES CertifiedDecember 16, 2022
✔ NPI 1639162480 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.
535 MILLER AVE, Mill Valley, CA 94941

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)

Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc 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 Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Dermatology
NPI 1780677526
535 MILLER AVE
Mill Valley, CA 94941
(415) 383-5475
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1245728807
535 MILLER AVE
Mill Valley, CA 94941
(415) 383-5475
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1801743992
535 MILLER AVE
Mill Valley, CA 94941
(415) 383-5475
✔ PECOSSame 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 Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc's NPI number?

The NPI number for Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc is 1639162480. It was assigned to this organization in the NPPES registry on August 26, 2005.

Where is Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc located?

Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc is located at 535 Miller Ave, Mill Valley, CA 94941. The listed phone number is (415) 383-5486.

What is Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc's specialty?

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

Is Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc enrolled in Medicare?

Yes. Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc, 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.

When was this NPI record last updated?

The NPPES record for Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc was last updated on December 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.