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VISAGE DERMATOLOGY, LLC
NPI 1932200045
Specialist in St Petersburg, FL

Active since September 25, 2006
5253 CENTRAL AVE, ST PETERSBURG, FL 33710(727) 388-6982 Get Directions Write a Review

NPPES record last updated: July 17, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Visage Dermatology, Llc NPPES

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

VISAGE DERMATOLOGY, LLC (NPI 1932200045) is a healthcare organization registered as a specialist in St Petersburg, Florida and active in the NPI registry since September 2006. The organization lists Alexandria Kongsiri, Physician, as its authorized official.

NPPES Registry Identity

NPI1932200045
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameVISAGE DERMATOLOGY, LLC
Location Address5253 CENTRAL AVESt Petersburg, FL 33710-8141
Mailing Address5253 Central AveSt Petersburg, FL 33710-8141 · (727) 388-6982
Phone(727) 388-6982
Organization SubpartNo
Authorized OfficialAlexandria KongsiriPhysician · (727) 388-6982
Enumeration DateSeptember 25, 2006
Last NPPES UpdateJuly 17, 2008
✔ NPI 1932200045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME83035
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
5253 CENTRAL AVE, St Petersburg, FL 33710
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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)

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

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Visage Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Christina Greene, APRN
Nurse Practitioner
NPI 1689202426
5253 CENTRAL AVE
Saint Petersburg, FL 33710
(727) 388-6982
✔ PECOS✔ Accepts MedicareSame address
Vishnu Harikumar, MD
Dermatology
NPI 1164009726
5253 CENTRAL AVE
St Petersburg, FL 33710
(727) 388-6982
✔ PECOS✔ Accepts MedicareSame address
Alexandria Kongsiri, M.D.
Dermatology
NPI 1740275791
5253 CENTRAL AVE
Saint Petersburg, FL 33710
(727) 388-6982
✔ PECOS✔ Accepts MedicareSame address
Randy Tang, MD
Dermatology
NPI 1285928275
5253 CENTRAL AVE
Saint Petersburg, FL 33710
(727) 388-6982
✔ PECOS✔ Accepts MedicareSame address
Gail Smith, APRN
Nurse Practitioner
NPI 1053374009
1839 CENTRAL AVE
St Petersburg, FL 33713
(727) 322-1054
✔ PECOS✔ Accepts Medicare2.8 mi
James Spencer, M.D.
Dermatology
NPI 1730102385
5013 96TH ST E
Palmetto, FL 34221
(727) 388-6982
✔ PECOS✔ Accepts Medicare17 mi
Keischa Cash, DNP, APRN, FNP-BC
Nurse Practitioner
NPI 1235380940
1503 W REYNOLDS ST
Plant City, FL 33563
(813) 514-4688
✔ PECOS✔ Accepts Medicare38 mi
Jessin Helmrick-Blossom, M.D.
Dermatology
NPI 1265661680
3320 SW 34TH CIR
Ocala, FL 34474
(352) 629-8154
✔ PECOS✔ Accepts Medicare101 mi
Sergey Arutyunyan, D.O.
Dermatology
NPI 1295274843
7031 SW 62ND AVE
South Miami, FL 33143
(305) 284-7761
✔ PECOS✔ Accepts Medicare206 mi

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 10D2247223

Visage Dermatology LLC · Saint Petersburg, FL
Expired · Oct 18, 2026
CLIA Number10D2247223
Laboratory TypePhysician Office
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorAlexandria S. Kongsiri
Laboratory Phone(727) 388-6982
Laboratory LocationVisage Dermatology LLC5253 Central Ave, Saint Petersburg, FL 33710
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D2311158

Visage Dermatology · Palmetto, FL
Expired · Sep 16, 2026
CLIA Number10D2311158
Laboratory TypePhysician Office
Certificate Effective DateSeptember 17, 2024
Certificate Expiration DateSeptember 16, 2026
Laboratory DirectorAlexandria S. Kongsiri
Laboratory Phone(727) 388-6982
Laboratory LocationVisage Dermatology5013 96th St E, Palmetto, FL 34221
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Visage Dermatology, LLC's NPI number?

The NPI number for Visage Dermatology, LLC is 1932200045. It was assigned to this organization in the NPPES registry on September 25, 2006.

Where is Visage Dermatology, LLC located?

Visage Dermatology, LLC is located at 5253 Central Ave, St Petersburg, FL 33710. The listed phone number is (727) 388-6982.

What is Visage Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Visage Dermatology, LLC enrolled in Medicare?

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

How many clinicians bill Medicare through Visage Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Visage 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. The largest specialties are Dermatology (6) and Nurse Practitioner (3). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Visage Dermatology, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Visage Dermatology, 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 Visage Dermatology, LLC was last updated on July 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.