Aqua Dermatology of Alabama PC
NPI 1477708642 · MOHS-Micrographic Surgery Physician · Vestavia Hls, AL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Aqua Dermatology of Alabama PC is a MOHS-Micrographic Surgery Physician organization in Vestavia Hls, AL (NPI 1477708642).
Provider details
- NPI number
- 1477708642
- Entity type
- Organization
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Karen Lake, Administration(205) 977-9786
- License
- 20579 (AL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
Other names (DBA / former)
- Doing business as
- Sunrise Dermatology
- Doing business as
- Surgical Dermatology Group
- Doing business as
- True Dermatology
Registry dates
- Enumerated
- 2008-12-01
- Last updated
- 2024-06-25
- Certified
- 2024-06-25
Frequently asked questions
- What is Aqua Dermatology of Alabama PC's NPI number?
- Aqua Dermatology of Alabama PC's National Provider Identifier (NPI) is 1477708642, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Aqua Dermatology of Alabama PC?
- Aqua Dermatology of Alabama PC is classified in the NPPES registry as MOHS-Micrographic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Aqua Dermatology of Alabama PC located?
- Aqua Dermatology of Alabama PC's practice location on file with NPPES is 1940 Stonegate Dr Ste 130, Vestavia Hls, AL 35242.
- What is Aqua Dermatology of Alabama PC's phone number?
- The practice phone number listed in the NPPES registry for Aqua Dermatology of Alabama PC is (205) 977-9876.
- Does Aqua Dermatology of Alabama PC accept Medicare?
- Aqua Dermatology of Alabama 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 Aqua Dermatology of Alabama PC?
- The authorized official listed on Aqua Dermatology of Alabama PC's NPPES record is Karen Lake, Administration. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Aqua Dermatology of Alabama PC's NPI active?
- Yes — Aqua Dermatology of Alabama PC's NPI (1477708642) is active in the NPPES registry as of the last update on 2024-06-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.