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CARROLLTON DERMATOLOGY
NPI 1699215541
Clinic/Center - Medical Specialty in Carrollton, GA

Active since February 26, 2017CLIA 11D2144831 · Certificate of Compliance
100 PROFESSIONAL PL, STE 110, CARROLLTON, GA 30117(770) 834-0818(770) 834-5098 Get Directions Write a Review

NPPES record last updated: February 26, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Carrollton Dermatology NPPES

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

CARROLLTON DERMATOLOGY (NPI 1699215541) is a healthcare organization registered as a medical specialty in Carrollton, Georgia and active in the NPI registry since February 2017. The organization holds a CLIA Certificate of Compliance certificate valid through January 16, 2027 and lists Mary M Feldman, Owner, as its authorized official.

NPPES Registry Identity

NPI1699215541
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameMARY M FELDMAN MD LLC
Location Address100 PROFESSIONAL PL, STE 110Carrollton, GA 30117-3874
Mailing Address100 Professional Pl, Ste 110Carrollton, GA 30117-3874 · (770) 834-0818 · Fax (770) 834-5098
Phone(770) 834-0818
Fax(770) 834-5098
Organization SubpartNo
Authorized OfficialMary M FeldmanOwner · (504) 231-5544
Enumeration DateFebruary 26, 2017
✔ NPI 1699215541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in GA · 69043
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
100 PROFESSIONAL PL, Carrollton, GA 30117
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Other Names 1

Doing Business AsCarrollton Dermatology

Other Identifiers 1

Medicare UPINH65098GA

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carrollton Dermatology 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 Carrollton Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mary Feldman, MD
Dermatology
NPI 1396767893
410 DIXIE ST
Carrollton, GA 30117
(770) 834-0818
✔ PECOS✔ Accepts Medicare0.2 mi

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 11D2144831

Carrollton Dermatology & Skin Cancer Associates · Carrollton, GA
Active · expires Jan 16, 2027
CLIA Number11D2144831
Laboratory TypePhysician Office
Certificate Effective DateJanuary 17, 2025
Certificate Expiration DateJanuary 16, 2027
Laboratory DirectorMary M. Feldman
Laboratory Phone(770) 834-0818
Laboratory LocationCarrollton Dermatology & Skin Cancer Associates410 Dixie Street, Carrollton, GA 30117
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Mary M Feldman MD LLC's NPI number?

The NPI number for Mary M Feldman MD LLC is 1699215541. It was assigned to this organization in the NPPES registry on February 26, 2017. The provider is doing business as Carrollton Dermatology.

Where is Mary M Feldman MD LLC located?

Mary M Feldman MD LLC is located at 100 Professional Pl Ste 110, Carrollton, GA 30117. The listed phone number is (770) 834-0818.

What is Mary M Feldman MD LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Mary M Feldman MD LLC enrolled in Medicare?

Yes. Mary M Feldman MD LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mary M Feldman MD LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Mary M Feldman MD 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.

Does Mary M Feldman MD LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 11D2144831) is associated with this NPI, valid through January 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mary M Feldman MD LLC was last updated on February 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.