THE DERMATOLOGY CENTER OF CONNECTICUT, LLC
NPI 1922633213
Dermatology in Wallingford, CT
About The Dermatology Center Of Connecticut, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE DERMATOLOGY CENTER OF CONNECTICUT, LLC (NPI 1922633213) is a healthcare organization registered as a dermatology in Wallingford, Connecticut and active in the NPI registry since March 2020. The organization lists Kimberly Ellen Boldon, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
The Dermatology Center Of Connecticut, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to The Dermatology Center Of Connecticut, LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 The Dermatology Center Of Connecticut, LLC's NPI number?
The NPI number for The Dermatology Center Of Connecticut, LLC is 1922633213. It was assigned to this organization in the NPPES registry on March 6, 2020.
Where is The Dermatology Center Of Connecticut, LLC located?
The Dermatology Center Of Connecticut, LLC is located at 60 Church St Unit 4B, Wallingford, CT 06492. The listed phone number is (203) 907-8474.
What is The Dermatology Center Of Connecticut, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is The Dermatology Center Of Connecticut, LLC enrolled in Medicare?
Yes. The Dermatology Center Of Connecticut, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through The Dermatology Center Of Connecticut, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to The Dermatology Center Of Connecticut, LLC, in Dermatology and Nurse Practitioner. 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.
What insurance does The Dermatology Center Of Connecticut, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list The Dermatology Center Of Connecticut, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for The Dermatology Center Of Connecticut, LLC was last updated on March 6, 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.
# The Dermatology Center Of Connecticut, Llc · NPI 1922633213
Dermatology organization in Wallingford, Connecticut. Organization record, active in the CMS NPPES registry since March 6, 2020.
## Identity
- **NPI:** 1922633213 (Entity type: Organization)
- **Enumerated:** March 6, 2020
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Kimberly Boldon, OWNER
## Practice location
- **Address:** 60 CHURCH ST UNIT 4B, Wallingford, CT 06492-2340
- **Phone:** (203) 907-8474
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (1), Nurse Practitioner (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1922633213) · Data from the CMS NPPES public registry.