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TIDEWATER DERMATOLOGY, LLC
NPI 1891188991
Dermatology in Berlin, MD

Active since March 13, 2015CLIA 21D2101795 · Microscopy
314 FRANKLIN AVE STE 401, BERLIN, MD 21811(410) 641-2222(844) 715-9464 Get Directions Write a Review

NPPES record last updated: February 18, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Tidewater Dermatology, Llc NPPES

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

TIDEWATER DERMATOLOGY, LLC (NPI 1891188991), doing business as Tidewater Dermatology, is a healthcare organization registered as a dermatology in Berlin, Maryland and active in the NPI registry since March 2015. The organization holds a CLIA Microscopy certificate valid through September 9, 2027 and lists Anne P Spillane, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1891188991
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameTIDEWATER DERMATOLOGY, LLC
Location Address314 FRANKLIN AVE STE 401Berlin, MD 21811-1263
Mailing Address314 Franklin Ave Ste 401Berlin, MD 21811-1263 · (410) 641-2222 · Fax (844) 715-9464
Phone(410) 641-2222
Fax(844) 715-9464
Organization SubpartNo
Authorized OfficialAnne P SpillaneManaging Partner · (410) 641-2222
Enumeration DateMarch 13, 2015
Last NPPES UpdateFebruary 18, 2026
NPPES CertifiedFebruary 18, 2026
✔ NPI 1891188991 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.
314 FRANKLIN AVE STE 401, Berlin, MD 21811
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Other Names 1

Doing Business AsTidewater Dermatology

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)

Tidewater Dermatology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Tidewater Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Anne Spillane, M.D.
Dermatology
NPI 1043415789
314 FRANKLIN AVE STE 401
Berlin, MD 21811
(410) 641-2222
✔ PECOS✔ Accepts MedicareSame address
Erin Spillane, M.D.
Dermatology
NPI 1033316823
314 FRANKLIN AVE STE 401
Berlin, MD 21811
(410) 641-2222
✔ 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) 21D2101795

Tidewater Dermatology · Berlin, MD
Active · expires Sep 9, 2027
CLIA Number21D2101795
Laboratory TypePhysician Office
Certificate Effective DateSeptember 10, 2025
Certificate Expiration DateSeptember 9, 2027
Laboratory DirectorErin L. Spillane
Laboratory Phone(410) 641-2222
Laboratory LocationTidewater Dermatology314 Franklin Ave, Suite 401, Berlin, MD 21811
CLIA data matches this NPI record on: Address 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 Tidewater Dermatology, LLC's NPI number?

The NPI number for Tidewater Dermatology, LLC is 1891188991. It was assigned to this organization in the NPPES registry on March 13, 2015. The provider is doing business as Tidewater Dermatology.

Where is Tidewater Dermatology, LLC located?

Tidewater Dermatology, LLC is located at 314 Franklin Ave Ste 401, Berlin, MD 21811. The listed phone number is (410) 641-2222.

What is Tidewater Dermatology, LLC's specialty?

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

Is Tidewater Dermatology, LLC enrolled in Medicare?

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

How many clinicians bill Medicare through Tidewater Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Tidewater 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tidewater Dermatology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D2101795) is associated with this NPI, valid through September 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tidewater Dermatology, LLC was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.