DECATUR DERMATOLOGY, PC – Dermatology Physician, NPI 1770782849

DECATUR DERMATOLOGY, PC is a healthcare provider. based in Decatur, Alabama. specializing in Dermatology Physician. The organization holds a License No. 00026547 (AL). The NPI Number for DECATUR DERMATOLOGY, PC is 1770782849

Main info

Organization
Name
DECATUR DERMATOLOGY, PC
NPI
1770782849
Phone
(256) 353-7775
Address
1316 SOMERVILLE RD SE
Authorized Official
SAMANTHA WYATT PHYSICIAN/PRESIDENT MD
Enumeration Date
17 July 2007
Last Update Date
21 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness85
Years active:18State licenses:1Digital endpointsOther names

Provider Addresses for DECATUR DERMATOLOGY, PC

  • 1316 SOMERVILLE RD SE

    SUITE 4

    DECATUR, AL 356014305

    Phone: (256) 353-7775

    Fax: (256) 353-7765

    Type: Mailing

  • 620 WALNUT STREET NE

    SUITE A

    DECATUR, AL 356012456

    Phone: (256) 353-7775

    Fax: (256) 353-7765

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-08-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (283 days ago).

Enrollment records

1

Earliest due date

2025-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050817000242OClinic/Group PracticeAL2025-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35601)

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Reviews

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Frequently asked questions

Can I cross-check DECATUR DERMATOLOGY, PC using NPI 1770782849?
NPI 1770782849 belongs to DECATUR DERMATOLOGY, PC; compare other details if you need extra assurance.
Is there an active status for DECATUR DERMATOLOGY, PC?
For scheduling context, DECATUR DERMATOLOGY, PC is shown as active in the registry.
What clinical focus is listed for DECATUR DERMATOLOGY, PC?
At a glance, DECATUR DERMATOLOGY, PC is tied to Dermatology Physician. Clinical services aligned with this taxonomy classification.
Is DECATUR DERMATOLOGY, PC associated with Decatur?
Public fields place DECATUR DERMATOLOGY, PC around Decatur, Alabama. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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