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JUVENTUD DERMATOLOGY PLLC
NPI 1831021062
Clinic/Center in Richland, WA

Active since June 02, 2026CLIA 50D2348668 · Waiver
140 GAGE BLVD STE 100, RICHLAND, WA 99352(509) 430-8102(509) 267-2833 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 30, 2026, Jun 2, 2026 (2 updates tracked since 2026).

About Juventud Dermatology Pllc NPPES

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

JUVENTUD DERMATOLOGY PLLC (NPI 1831021062) is a healthcare organization registered as a clinic/center in Richland, Washington and active in the NPI registry since June 2026. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Christina Rodriguez, Nurse Practitoner, as its authorized official.

NPPES Registry Identity

NPI1831021062
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameJUVENTUD DERMATOLOGY PLLC
Location Address140 GAGE BLVD STE 100Richland, WA 99352-8916
Mailing Address1033 Sunhaven PlRichland, WA 99352-9535 · (509) 430-8102 · Fax (509) 267-2833
Phone(509) 430-8102
Fax(509) 267-2833
Organization SubpartNo
Authorized OfficialChristina RodriguezNurse Practitoner · (509) 430-8102
Enumeration DateJune 2, 2026
Last NPPES UpdateJuly 30, 20262 updates tracked since enumeration
NPPES CertifiedJuly 30, 2026
✔ NPI 1831021062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
140 GAGE BLVD STE 100, Richland, WA 99352
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Juventud 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 Juventud Dermatology PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Christina Rodriguez, ARNP
Nurse Practitioner
NPI 1780285049
140 GAGE BLVD STE 100
Richland, WA 99352
(509) 267-3321
✔ PECOSSame 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 Waiver 50D2348668

Juventud Dermatology PLLC · Richland, WA
Active · expires Apr 4, 2028
CLIA Number50D2348668
Laboratory TypePhysician Office
Certificate Effective DateAugust 10, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorChristina Rodriguez
Laboratory Phone(509) 267-3321
Laboratory LocationJuventud Dermatology PLLC140 Gage Blvd, Suite 100, Richland, WA 99352
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Juventud Dermatology PLLC's NPI number?

The NPI number for Juventud Dermatology PLLC is 1831021062. It was assigned to this organization in the NPPES registry on June 2, 2026.

Where is Juventud Dermatology PLLC located?

Juventud Dermatology PLLC is located at 140 Gage Blvd Ste 100, Richland, WA 99352. The listed phone number is (509) 430-8102.

What is Juventud Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Juventud Dermatology PLLC enrolled in Medicare?

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

How many clinicians bill Medicare through Juventud Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Juventud 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 Juventud Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2348668) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Juventud Dermatology PLLC was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.