WOLVERINE DERMATOLOGY, PC
NPI 1679085161
Dermatology in Wyoming, MI
About Wolverine Dermatology, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WOLVERINE DERMATOLOGY, PC (NPI 1679085161) is a healthcare organization registered as a dermatology in Wyoming, Michigan and active in the NPI registry since October 2017. The organization holds a CLIA Certificate of Compliance certificate valid through August 30, 2028 and lists Ryan Dale Freeland, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Wolverine Dermatology, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Wolverine Dermatology, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. 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 of Compliance 23D2141314
Wolverine Dermatology · Wyoming, MIFrequently 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 Wolverine Dermatology, PC's NPI number?
The NPI number for Wolverine Dermatology, PC is 1679085161. It was assigned to this organization in the NPPES registry on October 25, 2017.
Where is Wolverine Dermatology, PC located?
Wolverine Dermatology, PC is located at 1673 Gezon Pkwy SW, Wyoming, MI 49519. The listed phone number is (616) 243-3376.
What is Wolverine Dermatology, PC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Wolverine Dermatology, PC enrolled in Medicare?
Yes. Wolverine Dermatology, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Wolverine Dermatology, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Wolverine Dermatology, PC. 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 (3) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Wolverine Dermatology, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 23D2141314) is associated with this NPI, valid through August 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Wolverine Dermatology, PC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Wolverine Dermatology, PC 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 Wolverine Dermatology, PC was last updated on February 28, 2023. 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.
# Wolverine Dermatology, Pc · NPI 1679085161
Dermatology organization in Wyoming, Michigan. Organization record, active in the CMS NPPES registry since October 25, 2017.
## Identity
- **NPI:** 1679085161 (Entity type: Organization)
- **Enumerated:** October 25, 2017
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Ryan Freeland, OWNER
## Practice location
- **Address:** 1673 GEZON PKWY SW, Wyoming, MI 49519-9519
- **Phone:** (616) 243-3376 · **Fax:** (616) 243-3377
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (3), Micrographic Dermatologic Surgery (MDS) (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 28, 2023
- **Other identifiers:** Other 23D2141314 (MI); Other 4301084275 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1679085161) · Data from the CMS NPPES public registry.