PREMIER DERMATOLOGY OF FLORIDA LLC
NPI 1952800112
Dermatology in St Augustine, FL

Active since February 02, 2018
109 WHITEHALL DR UNIT 117, ST AUGUSTINE, FL 32086(904) 460-2388(904) 460-2689 Get Directions Write a Review

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

About Premier Dermatology Of Florida Llc NPPES

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

PREMIER DERMATOLOGY OF FLORIDA LLC (NPI 1952800112) is a healthcare organization registered as a dermatology in St Augustine, Florida and active in the NPI registry since February 2018. The organization lists Joanna Lee Mcgetrick, Owner, as its authorized official.

NPPES Registry Identity

NPI1952800112
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePREMIER DERMATOLOGY OF FLORIDA LLC
Location Address109 WHITEHALL DR UNIT 117St Augustine, FL 32086-5266
Mailing Address109 Whitehall Dr Unit 117St Augustine, FL 32086-5266 · (904) 460-2388 · Fax (904) 460-2689
Fax(904) 460-2689
Organization SubpartNo
Authorized OfficialJoanna Lee McgetrickOwner · (863) 258-0601
Enumeration DateFebruary 2, 2018
Last NPPES UpdateJanuary 30, 2024
NPPES CertifiedJanuary 30, 2024
✔ NPI 1952800112 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.
109 WHITEHALL DR UNIT 117, St Augustine, FL 32086

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)

Premier Dermatology Of Florida Llc 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 Premier Dermatology Of Florida LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1184940777
109 WHITEHALL DR UNIT 117
St Augustine, FL 32086
(904) 460-2388
✔ 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 of Compliance 10D2250248

Premier Dematology Of Florida · St Augustine, FL
Expired · Oct 17, 2026
CLIA Number10D2250248
Laboratory TypePhysician Office
Certificate Effective DateOctober 18, 2024
Certificate Expiration DateOctober 17, 2026
Laboratory DirectorJoanna L. Mcgetrick
Laboratory Phone(904) 460-2388
Laboratory LocationPremier Dematology Of Florida109 Whitehall Dr Unit 117, St Augustine, FL 32086
CLIA data matches this NPI record on: Address 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 Premier Dermatology Of Florida LLC's NPI number?

The NPI number for Premier Dermatology Of Florida LLC is 1952800112. It was assigned to this organization in the NPPES registry on February 2, 2018.

Where is Premier Dermatology Of Florida LLC located?

Premier Dermatology Of Florida LLC is located at 109 Whitehall Dr Unit 117, St Augustine, FL 32086. The listed phone number is (904) 460-2388.

What is Premier Dermatology Of Florida LLC's specialty?

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

Is Premier Dermatology Of Florida LLC enrolled in Medicare?

Yes. Premier Dermatology Of Florida LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premier Dermatology Of Florida LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Premier Dermatology Of Florida 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premier Dermatology Of Florida LLC was last updated on January 30, 2024. 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.