GENESIS DERMATOLOGY – Dermatology Physician, NPI 1801093661

GENESIS DERMATOLOGY is a healthcare provider. based in Jupiter, Florida. specializing in Dermatology Physician. The NPI Number for GENESIS DERMATOLOGY is 1801093661

Main info

Organization
Name
GENESIS DERMATOLOGY
NPI
1801093661
Phone
(561) 296-5222
Address
600 HERITAGE DR
Authorized Official
SHAWNA FLANAGAN OWNER MD
Enumeration Date
27 June 2007
Last Update Date
21 February 2012
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:18State licenses:0Digital endpointsOther names

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Provider Addresses for GENESIS DERMATOLOGY

  • 600, Heritage Drive, Jupiter, Palm Beach County, Florida, 33458, United States

    SUITE 100

    JUPITER, FL 334583000

    Phone: (561) 296-5222

    Fax: (561) 296-5221

    Mailing address matches the actual address.

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: 2004-09-14

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040914000305OClinic/Group PracticeFLTBD

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.

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 33458)

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Reviews

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Frequently asked questions

Can I verify GENESIS DERMATOLOGY with an NPI only?
You can start verification with NPI 1801093661 for GENESIS DERMATOLOGY, then check state licensing separately.
Is GENESIS DERMATOLOGY listed as active for patients and plans?
The listing shows GENESIS DERMATOLOGY as active in the NPI system.
What is GENESIS DERMATOLOGY's specialty?
The listing groups GENESIS DERMATOLOGY with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect GENESIS DERMATOLOGY on a map?
Expect Jupiter, Florida as a primary anchor for GENESIS DERMATOLOGY unless the record lists multiple sites.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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