Orlando Dermatology Center – Dermatology Physician, NPI 1174078281
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Orlando Dermatology Center
Dr. Edward Stoner Way, Oviedo, Seminole County, Florida, 32765-8888, United States
OVIEDO, FL 32765
Phone: (407) 706-1770
Type: Location
4970 S US Highway 17/92
Casselberry, FL 327073888
Phone: (407) 635-8012
Type: Location
731 Stirling Center Pl
Lake Mary, FL 327465209
Phone: (407) 436-7375
Type: Location
422 S Alafaya Trl Ste 26
Orlando, FL 328288984
Phone: (407) 538-3855
Type: Location
7560 RED BUG LAKE RD STE 1014
OVIEDO, FL 327656591
Phone: (407) 706-1770
Fax: (407) 650-3455
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: 2017-02-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (799 days ago).
Enrollment records
1
Earliest due date
2024-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170201001161 | O | Clinic/Group Practice | FL | 2024-03-31 |
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.
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 32765)
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