PRAIRIE DERMATOLOGY, PLLC
NPI 1881333680
Dermatology in Bloomington, IL
About Prairie Dermatology, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRAIRIE DERMATOLOGY, PLLC (NPI 1881333680) is a healthcare organization registered as a dermatology in Bloomington, Illinois and active in the NPI registry since May 2022. The organization holds a CLIA Certificate of Compliance certificate valid through December 30, 2026 and lists Caitlyn Stoewer, Physician Assistant, 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)
Prairie 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 Prairie Dermatology, 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 14D2270251
Prairie Dermatology · Bloomington, ILFrequently 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 Prairie Dermatology, PLLC's NPI number?
The NPI number for Prairie Dermatology, PLLC is 1881333680. It was assigned to this organization in the NPPES registry on May 31, 2022.
Where is Prairie Dermatology, PLLC located?
Prairie Dermatology, PLLC is located at 1015 S Mercer Ave Ste Gf7, Bloomington, IL 61701. The listed phone number is (309) 660-8442.
What is Prairie Dermatology, PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Prairie Dermatology, PLLC enrolled in Medicare?
Yes. Prairie Dermatology, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prairie Dermatology, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Prairie 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 Prairie Dermatology, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 14D2270251) is associated with this NPI, valid through December 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Prairie Dermatology, PLLC was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.