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SUE KELLY DERMATOLOGY, LLC
NPI 1851573760
Dermatology - Dermatopathology in North Kingstown, RI

Active since December 03, 2007CLIA 41D1076705 · Microscopy
7 WEAVER RD, NORTH KINGSTOWN, RI 02852(401) 667-0905 Get Directions Write a Review

NPPES record last updated: July 7, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sue Kelly Dermatology, Llc NPPES

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

SUE KELLY DERMATOLOGY, LLC (NPI 1851573760) is a healthcare organization registered as a dermatopathology in North Kingstown, Rhode Island and active in the NPI registry since December 2007. The organization holds a CLIA Microscopy certificate valid through September 5, 2028 and lists Susan Christine Kelly, Physician, as its authorized official.

NPPES Registry Identity

NPI1851573760
Entity TypeOrganization
Primary Taxonomy207ND0900X
Legal Business NameSUE KELLY DERMATOLOGY, LLC
Location Address7 WEAVER RDNorth Kingstown, RI 02852-7135
Mailing Address7 Weaver RdNorth Kingstown, RI 02852-7135 · (401) 667-0905 · Fax (401) 667-0590
Phone(401) 667-0905
Organization SubpartNo
Authorized OfficialSusan Christine KellyPhysician · (401) 667-0905
Enumeration DateDecember 3, 2007
Last NPPES UpdateJuly 7, 2011
✔ NPI 1851573760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · DermatopathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ND0900X
License✔ Licensed in RI · DO00604
Definition
A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
7 WEAVER RD, North Kingstown, RI 02852
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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)

Sue Kelly Dermatology, Llc 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 Sue Kelly Dermatology, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Susan Kelly, D.O.
Dermatology
NPI 1548200074
7 WEAVER RD
North Kingstown, RI 02852
(401) 667-0905
✔ 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 for Provider-Performed Microscopy Procedures (PPMP) 41D1076705

Sue Kelly Dermatology LLC · North Kingstown, RI
Active · expires Sep 5, 2028
CLIA Number41D1076705
Laboratory TypePhysician Office
Certificate Effective DateSeptember 6, 2026
Certificate Expiration DateSeptember 5, 2028
Laboratory DirectorSusan C. Kelly
Laboratory Phone(401) 667-0905
Laboratory LocationSue Kelly Dermatology LLC7 Weavers Road, North Kingstown, RI 02852
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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 Sue Kelly Dermatology, LLC's NPI number?

The NPI number for Sue Kelly Dermatology, LLC is 1851573760. It was assigned to this organization in the NPPES registry on December 3, 2007.

Where is Sue Kelly Dermatology, LLC located?

Sue Kelly Dermatology, LLC is located at 7 Weaver Rd, North Kingstown, RI 02852. The listed phone number is (401) 667-0905.

What is Sue Kelly Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

Is Sue Kelly Dermatology, LLC enrolled in Medicare?

Yes. Sue Kelly Dermatology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sue Kelly Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Sue Kelly Dermatology, LLC. 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 Sue Kelly Dermatology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 41D1076705) is associated with this NPI, valid through September 5, 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 Sue Kelly Dermatology, LLC was last updated on July 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.