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BLUE RIBBON DERMATOLOGY PLLC
NPI 1962219535
Dermatology in Allen, TX

Active since December 16, 2024CLIA 45D2324835 · Certificate of Compliance
1150 N WATTERS RD STE 105, ALLEN, TX 75013(469) 331-3242(469) 331-3243 Get Directions Write a Review

NPPES record last updated: July 3, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 3, 2025, Jan 5, 2025, Dec 16, 2024 (3 updates tracked since 2024).

About Blue Ribbon Dermatology Pllc NPPES

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

BLUE RIBBON DERMATOLOGY PLLC (NPI 1962219535) is a healthcare organization registered as a dermatology in Allen, Texas and active in the NPI registry since December 2024. The organization holds a CLIA Certificate of Compliance certificate valid through March 11, 2028 and lists Nader Aboul-fettouh, Physician, as its authorized official.

NPPES Registry Identity

NPI1962219535
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBLUE RIBBON DERMATOLOGY PLLC
Location Address1150 N WATTERS RD STE 105Allen, TX 75013-5536
Mailing Address1150 N Watters Rd Ste 105Allen, TX 75013-5536
Phone(469) 331-3242
Fax(469) 331-3243
Organization SubpartNo
Authorized OfficialNader Aboul-fettouhPhysician · (469) 331-3242
Enumeration DateDecember 16, 2024
Last NPPES UpdateJuly 3, 20253 updates tracked since enumeration
NPPES CertifiedJuly 3, 2025
✔ NPI 1962219535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
1150 N WATTERS RD STE 105, Allen, TX 75013
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.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)

Blue Ribbon Dermatology Pllc 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 Blue Ribbon Dermatology PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nader Aboul-Fettouh, MD
Dermatology
NPI 1508360298
1150 N WATTERS RD STE 105
Allen, TX 75013
(469) 331-3242
✔ 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 45D2324835

Blue Ribbon Dermatology · Allen, TX
Active · expires Mar 11, 2028
CLIA Number45D2324835
Laboratory TypePharmacy
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorNader Aboul-Fettouh
Laboratory Phone(469) 331-3242
Laboratory LocationBlue Ribbon Dermatology1150 N Watters Rd Ste 105, Allen, TX 75013
CLIA data matches this NPI record on: Address 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 Blue Ribbon Dermatology PLLC's NPI number?

The NPI number for Blue Ribbon Dermatology PLLC is 1962219535. It was assigned to this organization in the NPPES registry on December 16, 2024.

Where is Blue Ribbon Dermatology PLLC located?

Blue Ribbon Dermatology PLLC is located at 1150 N Watters Rd Ste 105, Allen, TX 75013. The listed phone number is (469) 331-3242.

What is Blue Ribbon Dermatology PLLC's specialty?

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

Is Blue Ribbon Dermatology PLLC enrolled in Medicare?

Yes. Blue Ribbon Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blue Ribbon Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Blue Ribbon Dermatology PLLC. 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 Blue Ribbon Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D2324835) is associated with this NPI, valid through March 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Blue Ribbon Dermatology PLLC accept?

Health plans from Molina Healthcare list Blue Ribbon Dermatology PLLC 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 Blue Ribbon Dermatology PLLC was last updated on July 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.