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CHATTANOOGA MOHS SURGERY
NPI 1750059622
Dermatology - MOHS-Micrographic Surgery in Chattanooga, TN

Active since September 03, 2021CLIA 44D2188024 · Certificate of Compliance
2158 NORTHGATE PARK LN STE 106, CHATTANOOGA, TN 37415(423) 888-3376(423) 870-1480 Get Directions Write a Review

NPPES record last updated: July 10, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Chattanooga Mohs Surgery NPPES

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

CHATTANOOGA MOHS SURGERY (NPI 1750059622) is a healthcare organization registered as a mohs-micrographic surgery in Chattanooga, Tennessee and active in the NPI registry since September 2021. The organization holds a CLIA Certificate of Compliance certificate valid through November 1, 2026 and lists Jason Susong, Owner, as its authorized official.

NPPES Registry Identity

NPI1750059622
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameCHATTANOOGA DERMATOLOGY PLLC
Location Address2158 NORTHGATE PARK LN STE 106Chattanooga, TN 37415-6911
Mailing Address2158 Northgate Park Ln Ste 106Chattanooga, TN 37415-6911 · (423) 888-3376 · Fax (423) 870-1480
Phone(423) 888-3376
Fax(423) 870-1480
Organization SubpartNo
Authorized OfficialJason SusongOwner · (423) 888-3376
Enumeration DateSeptember 3, 2021
Last NPPES UpdateJuly 10, 2024
NPPES CertifiedJuly 10, 2024
✔ NPI 1750059622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
2158 NORTHGATE PARK LN STE 106, Chattanooga, TN 37415
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Other Names 1

Doing Business AsChattanooga Mohs Surgery

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chattanooga Mohs Surgery 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 Chattanooga Mohs Surgery, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jason Susong, MD
Dermatology
NPI 1235302787
2158 NORTHGATE PARK LN STE 106
Chattanooga, TN 37415
(423) 888-3376
✔ PECOS✔ Accepts MedicareSame address

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 44D2188024

Chattanooga Dermatology, PLLC Dba Chattanooga Mohs Surgery · Chattanooga, TN
Active · expires Nov 1, 2026
CLIA Number44D2188024
Laboratory TypePhysician Office
Certificate Effective DateNovember 2, 2024
Certificate Expiration DateNovember 1, 2026
Laboratory DirectorDr. Jason R. Susong
Laboratory Phone(423) 888-3376
Laboratory LocationChattanooga Dermatology, PLLC Dba Chattanooga Mohs Surgery2158 Northgate Park, Suite 106, Chattanooga, TN 37415
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 Chattanooga Dermatology PLLC's NPI number?

The NPI number for Chattanooga Dermatology PLLC is 1750059622. It was assigned to this organization in the NPPES registry on September 3, 2021. The provider is doing business as Chattanooga Mohs Surgery.

Where is Chattanooga Dermatology PLLC located?

Chattanooga Dermatology PLLC is located at 2158 Northgate Park Ln Ste 106, Chattanooga, TN 37415. The listed phone number is (423) 888-3376.

What is Chattanooga Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Chattanooga Dermatology PLLC enrolled in Medicare?

Yes. Chattanooga Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Chattanooga Dermatology PLLC?

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

Does Chattanooga Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 44D2188024) is associated with this NPI, valid through November 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Chattanooga Dermatology PLLC was last updated on July 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.