RADIANT SKIN DERMATOLOGY AND LASER,PLLC
NPI 1861738460
Dermatology in New York, NY
About Radiant Skin Dermatology And Laser,pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RADIANT SKIN DERMATOLOGY AND LASER,PLLC (NPI 1861738460) is a healthcare organization registered as a dermatology in New York, New York and active in the NPI registry since December 2012. The organization lists Adebola Olufunmi Dele-michael, 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)
Radiant Skin Dermatology And Laser,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 Radiant Skin Dermatology And Laser,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.
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 Radiant Skin Dermatology And Laser,pllc's NPI number?
The NPI number for Radiant Skin Dermatology And Laser,pllc is 1861738460. It was assigned to this organization in the NPPES registry on December 31, 2012.
Where is Radiant Skin Dermatology And Laser,pllc located?
Radiant Skin Dermatology And Laser,pllc is located at 207 W 115th St Lowr Level, New York, NY 10026. The listed phone number is (212) 229-0007.
What is Radiant Skin Dermatology And Laser,pllc's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Radiant Skin Dermatology And Laser,pllc enrolled in Medicare?
Yes. Radiant Skin Dermatology And Laser,pllc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Radiant Skin Dermatology And Laser,pllc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Radiant Skin Dermatology And Laser,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.
When was this NPI record last updated?
The NPPES record for Radiant Skin Dermatology And Laser,pllc was last updated on March 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.