NORTHEASTERN DERMATOLOGY PLLC
NPI 1700490182
Dermatology in Rocky Mount, NC

Active since September 03, 2020
135 WOODRIDGE CT, ROCKY MOUNT, NC 27804(252) 903-1372 Get Directions Write a Review

NPPES record last updated: September 3, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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

NPI1700490182
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNORTHEASTERN DERMATOLOGY PLLC
Location Address135 WOODRIDGE CTRocky Mount, NC 27804-2294
Mailing Address135 Woodridge CtRocky Mount, NC 27804-2294 · (252) 903-1372
Organization SubpartNo
Authorized OfficialWillis E MartinOwner/physician · (252) 903-1372
Enumeration DateSeptember 3, 2020
NPPES CertifiedSeptember 3, 2020
✔ NPI 1700490182 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.
135 WOODRIDGE CT, Rocky Mount, NC 27804

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)

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)

Dermatology
NPI 1902042278
9948 N MAIN ST UNIT 1
Berlin, MD 21811
(410) 921-3376
✔ PECOS✔ Accepts Medicare219 mi

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.