NORTHEASTERN DERMATOLOGY PLLC
NPI 1700490182
Dermatology in Rocky Mount, NC
About Northeastern Dermatology Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHEASTERN DERMATOLOGY PLLC (NPI 1700490182) is a healthcare organization registered as a dermatology in Rocky Mount, North Carolina and active in the NPI registry since September 2020. The organization lists Willis E Martin, Owner/physician, 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)
Northeastern Dermatology Pllc 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 Northeastern Dermatology PLLC, 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 Northeastern Dermatology PLLC's NPI number?
The NPI number for Northeastern Dermatology PLLC is 1700490182. It was assigned to this organization in the NPPES registry on September 3, 2020.
Where is Northeastern Dermatology PLLC located?
Northeastern Dermatology PLLC is located at 135 Woodridge Ct, Rocky Mount, NC 27804. The listed phone number is (252) 903-1372.
What is Northeastern Dermatology PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Northeastern Dermatology PLLC enrolled in Medicare?
Yes. Northeastern Dermatology PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northeastern Dermatology PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Northeastern Dermatology PLLC. 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 Northeastern Dermatology PLLC was last updated on September 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.