UPSTATE DERMATOPATHOLOGY PLLC
NPI 1790567774
Dermatology - Dermatopathology in Williamsville, NY
About Upstate Dermatopathology Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UPSTATE DERMATOPATHOLOGY PLLC (NPI 1790567774) is a healthcare organization registered as a dermatopathology in Williamsville, New York and active in the NPI registry since October 2023. The organization holds a CLIA Certificate of Compliance certificate valid through March 26, 2027 and lists Liaqat Ali, Medical Director/owner, 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)
Upstate Dermatopathology 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 Upstate Dermatopathology 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.
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 33D2291979
Upstate Dermatopathology PLLC · Williamsville, NYFrequently 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 Upstate Dermatopathology PLLC's NPI number?
The NPI number for Upstate Dermatopathology PLLC is 1790567774. It was assigned to this organization in the NPPES registry on October 16, 2023.
Where is Upstate Dermatopathology PLLC located?
Upstate Dermatopathology PLLC is located at 6400 Sheridan Dr Ste 224, Williamsville, NY 14221. The listed phone number is (716) 334-0357.
What is Upstate Dermatopathology PLLC's specialty?
The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.
Is Upstate Dermatopathology PLLC enrolled in Medicare?
Yes. Upstate Dermatopathology PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Upstate Dermatopathology PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Upstate Dermatopathology 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 Upstate Dermatopathology PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 33D2291979) is associated with this NPI, valid through March 26, 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 Upstate Dermatopathology PLLC was last updated on October 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Upstate Dermatopathology Pllc · NPI 1790567774
Dermatopathology organization in Williamsville, New York. Organization record, active in the CMS NPPES registry since October 16, 2023.
## Identity
- **NPI:** 1790567774 (Entity type: Organization)
- **Enumerated:** October 16, 2023
- **Primary specialty:** Dermatology - Dermatopathology · taxonomy 207ND0900X
- **Organization subpart:** No
- **Authorized official:** Liaqat Ali, MEDICAL DIRECTOR/OWNER
## Practice location
- **Address:** 6400 SHERIDAN DR STE 224, Williamsville, NY 14221-4842
- **Phone:** (716) 334-0357
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Dermatology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 16, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1790567774) · Data from the CMS NPPES public registry.