Academic Alliance in Dermatology – Dermatology Physician, NPI 1538119722
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Academic Alliance in Dermatology
2044 Trinity Oaks Blvd Ste 130
Trinity, FL 346554405
Phone: (727) 375-5961
Fax: (727) 376-8710
Type: Location
1306 CONCOURSE DR STE 201
LINTHICUM HEIGHTS, MD 210901033
Phone:
Type: Mailing
3950 3rd St N Ste A
St Petersburg, FL 337036123
Phone: (727) 821-0612
Fax: (707) 822-5507
Type: Location
4238 W Kennedy Blvd
Tampa, FL 336092231
Phone: (813) 879-6040
Fax: (813) 879-6043
Type: Location
4700 N Habana Ave Ste 303
Tampa, FL 336147118
Phone: (813) 341-3285
Fax: (813) 341-3284
Type: Location
6331 Memorial Hwy Ste D
Tampa, FL 336154537
Phone: (813) 822-9986
Fax: (813) 882-9849
Type: Location
646 Virginia St Ste 201
Dunedin, FL 346986612
Phone: (727) 270-7291
Fax: (727) 823-7043
Type: Location
6600 University Pkwy Ste 302
Sarasota, FL 342409048
Phone: (940) 800-5001
Fax: (941) 800-5012
Type: Location
6776 54th Ave N
St Petersburg, FL 337091405
Phone: (727) 935-0510
Fax: (727) 935-0511
Type: Location
6901 Simmons Loop Ste 207
Riverview, FL 335789498
Phone: (813) 868-3052
Fax: (813) 868-3046
Type: Location
2919 W Swann Ave Ste 205
Tampa, FL 336094050
Phone: (813) 514-8985
Fax: (813) 514-8983
Type: Location
2438 Bloomingdale Ave
Valrico, FL 335966403
Phone: (813) 440-5544
Fax: (813) 440-5545
Type: Location
2412 Cypress Glen Dr Ste 102
Wesley Chapel, FL 335444603
Phone: (813) 341-1480
Fax: (813) 528-8730
Type: Location
1801 N Belcher Rd Ste B
Clearwater, FL 337651452
Phone: (727) 935-0503
Fax: (727) 935-0504
Type: Location
1503 W Reynolds St
Plant City, FL 335634733
Phone: (813) 514-4688
Fax: (813) 341-3288
Type: Location
1005 E Boyer St
Tarpon Springs, FL 346895501
Phone: (727) 934-7638
Fax: (727) 944-4052
Type: Location
1201 S Myrtle Ave
Clearwater, FL 337563424
Phone: (727) 442-1917
Fax: (727) 446-3490
Type: Location
13321 N 56th St
Tampa, FL 336171161
Phone: (813) 341-1488
Fax: (813) 341-1489
Type: Location
13910 Fivay Rd Ste 5
Hudson, FL 346677130
Phone: (727) 259-7930
Fax: (727) 935-0505
Type: Location
3190 N McMullen Booth Rd Ste 203
Clearwater, FL 337612013
Phone: (727) 258-9143
Fax: (727) 823-7043
Type: Location
1260 West Bay Dr
Ste C and F
Largo, FL 337702285
Phone: (727) 935-0500
Fax: (727) 935-0501
Type: Location
HCA Florida - West Tampa Hospital, 6001, Webb Road, Penner, Tampa, Hillsborough County, Florida, 33615, United States
TAMPA, FL 336154518
Phone: (813) 882-9986
Fax: (813) 882-9849
Type: Location
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: 2004-05-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
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 |
|---|---|---|---|---|
| O20040511001288 | O | Clinic/Group Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 34655)
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