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SKIN SECRETS DERMATOLOGY AESTHETICS AND WELLNESS
NPI 1881431633
Dermatology in Park Ridge, NJ

Active since July 10, 2024CLIA 31D2307635 · Waiver
70 PARK AVE UNIT 3, PARK RIDGE, NJ 07656(201) 582-8015(201) 277-4372 Get Directions Write a Review

NPPES record last updated: July 31, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 31, 2024, Jul 10, 2024 (2 updates tracked since 2024).

About Skin Secrets Dermatology Aesthetics And Wellness NPPES

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

SKIN SECRETS DERMATOLOGY AESTHETICS AND WELLNESS (NPI 1881431633) is a healthcare organization registered as a dermatology in Park Ridge, New Jersey and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through July 10, 2028 and lists Sophia Reid, Owner/medical Director, as its authorized official.

NPPES Registry Identity

NPI1881431633
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSKIN SECRETS WELLNESS PC
Location Address70 PARK AVE UNIT 3Park Ridge, NJ 07656-1239
Mailing Address70 Park Ave Unit 3Park Ridge, NJ 07656-1239 · (201) 582-8015 · Fax (201) 277-4372
Phone(201) 582-8015
Fax(201) 277-4372
Organization SubpartNo
Authorized OfficialSophia ReidOwner/medical Director · (201) 582-8015
Enumeration DateJuly 10, 2024
Last NPPES UpdateJuly 31, 20242 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1881431633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
70 PARK AVE UNIT 3, Park Ridge, NJ 07656
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Other Names 1

Doing Business AsSkin Secrets Dermatology Aesthetics And Wellness

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)

Skin Secrets Dermatology Aesthetics And Wellness 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 Skin Secrets Dermatology Aesthetics And Wellness, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sophia Reid, M.D.
Dermatology
NPI 1265877161
70 PARK AVE UNIT 3
Park Ridge, NJ 07656
(201) 582-8015
✔ 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 of Waiver 31D2307635

Skin Secrets Wellness PC Dba Skin Secrets Dermatology Aesthetics And Wellness · Park Ridge, NJ
Active · expires Jul 10, 2028
CLIA Number31D2307635
Laboratory TypePhysician Office
Certificate Effective DateJuly 11, 2026
Certificate Expiration DateJuly 10, 2028
Laboratory DirectorSophia D. Reid
Laboratory Phone(201) 582-8015
Laboratory LocationSkin Secrets Wellness PC Dba Skin Secrets Dermatology Aesthetics And Wellness70 Park Avenue Unit #3, Park Ridge, NJ 07656
CLIA data matches this NPI record on: Name Phone
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 Skin Secrets Wellness PC's NPI number?

The NPI number for Skin Secrets Wellness PC is 1881431633. It was assigned to this organization in the NPPES registry on July 10, 2024. The provider is doing business as Skin Secrets Dermatology Aesthetics And Wellness.

Where is Skin Secrets Wellness PC located?

Skin Secrets Wellness PC is located at 70 Park Ave Unit 3, Park Ridge, NJ 07656. The listed phone number is (201) 582-8015.

What is Skin Secrets Wellness PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Skin Secrets Wellness PC enrolled in Medicare?

Yes. Skin Secrets Wellness PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Skin Secrets Wellness PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Skin Secrets Wellness PC. 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 Skin Secrets Wellness PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2307635) is associated with this NPI, valid through July 10, 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 Skin Secrets Wellness PC was last updated on July 31, 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.