SUPER DERMATOLOGY LLC
NPI 1669971776
Dermatology in Conyers, GA
About Super Dermatology Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUPER DERMATOLOGY LLC (NPI 1669971776) is a healthcare organization registered as a dermatology in Conyers, Georgia and active in the NPI registry since February 2018. The organization lists Dione Marcus Super, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Super Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Super Dermatology LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Super Dermatology LLC's NPI number?
The NPI number for Super Dermatology LLC is 1669971776. It was assigned to this organization in the NPPES registry on February 3, 2018.
Where is Super Dermatology LLC located?
Super Dermatology LLC is located at 1364 Wellbrook Cir NE, Conyers, GA 30012. The listed phone number is (770) 285-3533.
What is Super Dermatology LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Super Dermatology LLC enrolled in Medicare?
Yes. Super Dermatology LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Super Dermatology LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Super Dermatology 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Super Dermatology LLC was last updated on February 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.