1. Home
  2. Directory
  3. Connecticut
  4. Glastonbury
  5. Dermatology
  6. NPI Profile

DERMATOLOGY ASSOCIATES OF EASTERN CT LLC
NPI 1952481418
Dermatology in Glastonbury, CT

Active since October 17, 2006CLIA 07D0723558 · Microscopy
622 HEBRON AVE STE 107, GLASTONBURY, CT 06033(860) 657-3376(860) 633-6040 Get Directions Write a Review

NPPES record last updated: December 11, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 11, 2023, Sep 10, 2018 (2 updates tracked since 2018).

About Dermatology Associates Of Eastern Ct Llc NPPES

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

DERMATOLOGY ASSOCIATES OF EASTERN CT LLC (NPI 1952481418) is a healthcare organization registered as a dermatology in Glastonbury, Connecticut and active in the NPI registry since October 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2028 and lists Laura A Benedetto, Partner, as its authorized official.

NPPES Registry Identity

NPI1952481418
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY ASSOCIATES OF EASTERN CT LLC
Location Address622 HEBRON AVE STE 107Glastonbury, CT 06033-5003
Mailing Address622 Hebron Ave Ste 107Glastonbury, CT 06033-5003 · (860) 657-3376 · Fax (860) 633-6040
Phone(860) 657-3376
Fax(860) 633-6040
Organization SubpartNo
Authorized OfficialLaura A BenedettoPartner · (860) 657-3376
Enumeration DateOctober 17, 2006
Last NPPES UpdateDecember 11, 20232 updates tracked since enumeration
NPPES CertifiedDecember 11, 2023
✔ NPI 1952481418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CT · 000275
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.
622 HEBRON AVE STE 107, Glastonbury, CT 06033
Open in Google Maps ↗

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)

Dermatology Associates Of Eastern Ct Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Dermatology Associates Of Eastern Ct LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Whitney Giauque, APRN
Nurse Practitioner
NPI 1558142034
622 HEBRON AVE STE 107
Glastonbury, CT 06033
(860) 657-3376
✔ PECOS✔ Accepts MedicareSame address
Maria Cosimini, NP
Nurse Practitioner
NPI 1699515536
622 HEBRON AVE STE 107
Glastonbury, CT 06033
(860) 657-3376
✔ PECOS✔ Accepts MedicareSame address
Kathryn Leone, APRN
Nurse Practitioner
NPI 1396570206
622 HEBRON AVE
Glastonbury, CT 06033
(860) 657-3376
✔ PECOS✔ Accepts MedicareSame address
Clara Hyland-Williams, NP
Nurse Practitioner
NPI 1194492694
210 NEW LONDON TPKE
Glastonbury, CT 06033
(860) 633-1543
✔ PECOS✔ Accepts Medicare0.9 mi
Laura Benedetto, D.O.
Osteopathic Manipulative Medicine
NPI 1710951009
263 FARMINGTON AVE
Farmington, CT 06030
(860) 679-4600
✔ PECOS✔ Accepts Medicare11 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

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) 07D0723558

Dermatology Associates Of Eastern Connecticut, LLC · Glastonbury, CT
Active · expires Aug 31, 2028
CLIA Number07D0723558
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorLaura G. Benedetto, Do
Laboratory Phone(860) 657-3376
Laboratory LocationDermatology Associates Of Eastern Connecticut, LLC622 Hebron Avenue Suite 107, Glastonbury, CT 06033
CLIA data matches this NPI record on: Address 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 Dermatology Associates Of Eastern Ct LLC's NPI number?

The NPI number for Dermatology Associates Of Eastern Ct LLC is 1952481418. It was assigned to this organization in the NPPES registry on October 17, 2006.

Where is Dermatology Associates Of Eastern Ct LLC located?

Dermatology Associates Of Eastern Ct LLC is located at 622 Hebron Ave Ste 107, Glastonbury, CT 06033. The listed phone number is (860) 657-3376.

What is Dermatology Associates Of Eastern Ct LLC's specialty?

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

Is Dermatology Associates Of Eastern Ct LLC enrolled in Medicare?

Yes. Dermatology Associates Of Eastern Ct LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology Associates Of Eastern Ct LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Dermatology Associates Of Eastern Ct 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 Nurse Practitioner (4) and Osteopathic Manipulative Medicine (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology Associates Of Eastern Ct LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 07D0723558) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermatology Associates Of Eastern Ct LLC was last updated on December 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.