CLINICAL DERMATOLOGY CENTER, LLC
NPI 1902428709
Dermatology in Chantilly, VA
About Clinical Dermatology Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLINICAL DERMATOLOGY CENTER, LLC (NPI 1902428709) is a healthcare organization registered as a dermatology in Chantilly, Virginia and active in the NPI registry since May 2020. The organization holds 2 active CLIA laboratory certificates and lists Mikhail A Pavlov, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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)
Clinical Dermatology Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Clinical Dermatology Center, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
Upland, PA 19013
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 2
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 49D2198182
Clinical Dermatology Center - Chantilly · Chantilly, VACertificate for Provider-Performed Microscopy Procedures (PPMP) 49D2320563
Clinical Dermatology Center, Arlington Office · Arlington, VAFrequently 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 Clinical Dermatology Center, LLC's NPI number?
The NPI number for Clinical Dermatology Center, LLC is 1902428709. It was assigned to this organization in the NPPES registry on May 14, 2020.
Where is Clinical Dermatology Center, LLC located?
Clinical Dermatology Center, LLC is located at 14500 Avion Pkwy Ste 100, Chantilly, VA 20151. The listed phone number is (703) 705-7000.
What is Clinical Dermatology Center, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Clinical Dermatology Center, LLC enrolled in Medicare?
Yes. Clinical Dermatology Center, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Clinical Dermatology Center, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Clinical Dermatology Center, 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. The largest specialties are Dermatology (5) and Pathology (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Clinical Dermatology Center, LLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Clinical Dermatology Center, LLC was last updated on July 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Clinical Dermatology Center, Llc · NPI 1902428709
Dermatology organization in Chantilly, Virginia. Organization record, active in the CMS NPPES registry since May 14, 2020.
## Identity
- **NPI:** 1902428709 (Entity type: Organization)
- **Enumerated:** May 14, 2020
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Mikhail Pavlov, PRACTICE MANAGER
## Practice location
- **Address:** 14500 AVION PKWY STE 100, Chantilly, VA 20151-1108
- **Phone:** (703) 705-7000 · **Fax:** (703) 763-7255
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (5), Pathology (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 17, 2020
- **Other identifiers:** Other 1578682894
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902428709) · Data from the CMS NPPES public registry.