Southern Dermatology Center, PC
NPI 1336172634 · Dermatology Physician · Decatur, AL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Dermatology Center, PC is a Dermatology Physician organization in Decatur, AL (NPI 1336172634).
Provider details
- NPI number
- 1336172634
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Angelo Mancuso, Owner(256) 351-9077
- License
- D0196 (AL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-07-09
- Last updated
- 2009-04-07
Frequently asked questions
- What is Southern Dermatology Center, PC's NPI number?
- Southern Dermatology Center, PC's National Provider Identifier (NPI) is 1336172634, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Dermatology Center, PC?
- Southern Dermatology Center, PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Southern Dermatology Center, PC located?
- Southern Dermatology Center, PC's practice location on file with NPPES is 2828 Highway 31 S, Decatur, AL 35603-1510.
- What is Southern Dermatology Center, PC's phone number?
- The practice phone number listed in the NPPES registry for Southern Dermatology Center, PC is (256) 351-9077.
- Does Southern Dermatology Center, PC accept Medicare?
- Southern Dermatology Center, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Dermatology Center, PC?
- The authorized official listed on Southern Dermatology Center, PC's NPPES record is Angelo Mancuso, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Dermatology Center, PC's NPI active?
- Yes — Southern Dermatology Center, PC's NPI (1336172634) is active in the NPPES registry as of the last update on 2009-04-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.