LUMINARY DERMATOLOGY, PA
NPI 1851955983
Dermatology - MOHS-Micrographic Surgery in Bradenton, FL
NPI Status: Active since April 24, 2019
Contact Information
2101 61ST ST W
BRADENTON, FL
ZIP 34209
Phone: (941) 926-6553
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- Accepts Insurance
- CLIA Number: 10D2251108
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-04-2026
About LUMINARY DERMATOLOGY, PA
This page provides the complete NPI Profile along with additional information for Luminary Dermatology, Pa, a provider established in Bradenton, Florida operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1851955983 assigned on April 2019. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated one year ago. Luminary Dermatology, Pa operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Jessica Lynn Phillips (Ceo)
- NPI
- 1851955983
- Provider Name
- LUMINARY DERMATOLOGY, PA
- Entity Type
- Organization
- Location Address
- 2101 61ST ST W BRADENTON, FL 34209
- Location Phone
- (941) 926-6553
- Mailing Address
- 4411 BEE RIDGE RD PMB 309 SARASOTA, FL 34233
- Mailing Phone
- (941) 926-6553
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-24-2019
- Last Update Date
- 01-27-2025
- Code Navigator
Location Map
Secondary Locations
- 8740 N Kendall Dr Ste 101
Miami, FL 33176
(305) 661-8978 - 819 N Mills Ave Ste D
Arcadia, FL 34266
(863) 491-2390 - 3105 Bobcat Village Center Rd
North Port, FL 34288
(941) 271-0021 - 2032 Hawthorne St
Sarasota, FL 34239
(941) 926-6553 - 1901 Haverford Ave
Sun City Center, FL 33573
(941) 926-6553 - 16870 NE 19th Ave
North Miami Beach, FL 33162
(305) 947-1466 - 1250 S Tamiami Trl Ste 304
Sarasota, FL 34239
(941) 263-2988 - 544 Bay Isles Rd
Longboat Key, FL 34228
(941) 926-6553 - 925 NE 30th Ter Ste 308
Homestead, FL 33033
(786) 670-9799 - 1550 E Venice Ave
Venice, FL 34292
(941) 667-9030
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 174400000X | Other Service Providers | Specialist | |
| 2 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | |
| 3 | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 4 | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | |
| 5 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
| 6 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | |
| 7 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 8 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 9 | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AvMed Entrust Bronze 600 (2026) - HMO
- AvMed Entrust Bronze 650 (2026) - HMO
- AvMed Entrust Expanded Bronze Standard (2026) - HMO
- AvMed Entrust Gold 125 (2026) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
- AvMed Entrust Gold Standard (2026) - HMO
- AvMed Entrust Platinum 25 (2026) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
- AvMed Entrust Platinum Standard (2026) - HMO
- AvMed Entrust Silver 350 (2026) - HMO
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-06 (Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-05 (Rewards) - POS
- BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-18 (Rewards) - POS
- BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| B8XVQ | OTHER (01) | FL | FLORIDA BLUE |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2251108
- Facility Type
- Physician Office
- Certificate Effective Date
- December 05, 2024
- Certificate Expiration Date
- December 04, 2026
- Laboratory Director
- CARY DUNN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Luminary Dermatology, Pa after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1851955983, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1851955983, enumerated as an "organization" on April 24, 2019.
The provider is located at 2101 61ST ST W BRADENTON, FL 34209 and the phone number is (941) 926-6553.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
The provider might be accepting Accepts: AvMed, Florida Blue (BlueCross BlueShield FL),. Please consult your insurance carrier or call the provider to verify.
