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ELITE DERMATOLOGY
NPI 1902452360
Dermatology in Las Cruces, NM

Active since August 12, 2019CLIA 32D2173896 · Microscopy
1005 S TELSHOR BLVD STE A, LAS CRUCES, NM 88011(575) 262-7546(575) 888-2273 Get Directions Write a Review

NPPES record last updated: December 30, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 30, 2024, Dec 20, 2024, Jan 21, 2023 and 1 more (4 updates tracked since 2019).

About Elite Dermatology NPPES

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

ELITE DERMATOLOGY (NPI 1902452360) is a healthcare organization registered as a dermatology in Las Cruces, New Mexico and active in the NPI registry since August 2019. The organization holds a CLIA Microscopy certificate valid through October 21, 2027 and lists Kristin Autry, Manager, as its authorized official.

NPPES Registry Identity

NPI1902452360
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameELITE AESTHETICS
Location Address1005 S TELSHOR BLVD STE ALas Cruces, NM 88011-4879
Mailing AddressPo Box 871Las Cruces, NM 88004-0871 · (409) 719-8846 · Fax (575) 888-2273
Phone(575) 262-7546
Fax(575) 888-2273
Organization SubpartNo
Authorized OfficialKristin AutryManager · (707) 770-9990
Enumeration DateAugust 12, 2019
Last NPPES UpdateDecember 30, 20244 updates tracked since enumeration
NPPES CertifiedDecember 30, 2024
✔ NPI 1902452360 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.
1005 S TELSHOR BLVD STE A, Las Cruces, NM 88011
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Other Names 1

Doing Business AsElite Dermatology

Other Identifiers 1

Medicaid10222880NM

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)

Elite Dermatology 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 Elite Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tiffany Autry, DNP FNP MEP-C
Nurse Practitioner
NPI 1003389875
1005 S TELSHOR BLVD STE A
Las Cruces, NM 88011
(575) 262-7546
✔ 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) 32D2173896

Elite Aesthetics · Las Cruces, NM
Active · expires Oct 21, 2027
CLIA Number32D2173896
Laboratory TypePhysician Office
Certificate Effective DateOctober 22, 2025
Certificate Expiration DateOctober 21, 2027
Laboratory DirectorTiffany Autry
Laboratory Phone(575) 262-7546
Laboratory LocationElite Aesthetics1005 S Telshor Blvd, Suite A, Las Cruces, NM 88011
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 Elite Aesthetics's NPI number?

The NPI number for Elite Aesthetics is 1902452360. It was assigned to this organization in the NPPES registry on August 12, 2019. The provider is doing business as Elite Dermatology.

Where is Elite Aesthetics located?

Elite Aesthetics is located at 1005 S Telshor Blvd Ste A, Las Cruces, NM 88011. The listed phone number is (575) 262-7546.

What is Elite Aesthetics's specialty?

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

Is Elite Aesthetics enrolled in Medicare?

Yes. Elite Aesthetics is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Elite Aesthetics?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Elite Aesthetics. 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 Elite Aesthetics hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 32D2173896) is associated with this NPI, valid through October 21, 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 Elite Aesthetics was last updated on December 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.