BRANDON DERMATOLOGY P A
NPI 1760504682
Dermatology in Brandon, FL
About Brandon Dermatology P A NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRANDON DERMATOLOGY P A (NPI 1760504682) is a healthcare organization registered as a dermatology in Brandon, Florida and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Andres Tobon, Presidentphysician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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)
Brandon Dermatology P A is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Brandon Dermatology P A, 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 (6)
Jackson, MS 39216
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 2
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 Waiver 10D2275813
Brandon Dermatology, PA · Brandon, FLCertificate of Compliance 10D2020895
Brandon Dermatology PA · Brandon, FLFrequently 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 Brandon Dermatology P A's NPI number?
The NPI number for Brandon Dermatology P A is 1760504682. It was assigned to this organization in the NPPES registry on April 3, 2007.
Where is Brandon Dermatology P A located?
Brandon Dermatology P A is located at 405 W Bloomingdale Ave, Brandon, FL 33511. The listed phone number is (813) 662-3376.
What is Brandon Dermatology P A's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Brandon Dermatology P A enrolled in Medicare?
Yes. Brandon Dermatology P A is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Brandon Dermatology P A?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Dermatology, reassign their Medicare billing to Brandon Dermatology P A. 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. 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 Brandon Dermatology P A hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Brandon Dermatology P A accept?
Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Brandon Dermatology P A 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 Brandon Dermatology P A was last updated on September 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Brandon Dermatology P A · NPI 1760504682
Dermatology organization in Brandon, Florida. Organization record, active in the CMS NPPES registry since April 3, 2007.
## Identity
- **NPI:** 1760504682 (Entity type: Organization)
- **Enumerated:** April 3, 2007
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Andres Tobon, PRESIDENTPHYSICIAN
## Practice location
- **Address:** 405 W BLOOMINGDALE AVE, Brandon, FL 33511-7401
- **Phone:** (813) 662-3376 · **Fax:** (813) 662-3009
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 19, 2008
- **Other identifiers:** Other AL785 (FL)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1760504682) · Data from the CMS NPPES public registry.