Orsini Surgical Dermatology SC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

ORSINI SURGICAL DERMATOLOGY SC

Practice address

1519 Legacy Cir
Naperville, IL 60563-3161

Phone

(630) 300-0015

Fax

(630) 300-0014

NPI assigned

Oct 17, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amy Priess OrsiniNPI 1013933431

Title

MD

Phone

(630) 300-0015

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy P Orsini, MD

  • MOHS-Micrographic Surgery Physician
  • Naperville, IL
  • NPI 1013933431

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Maria Josefina Quintanilla-Dieck, M.D.

  • MOHS-Micrographic Surgery Physician
  • Naperville, IL
  • NPI 1457518490

  Dermatology

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1013559400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 LEGACY CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633161",
            "telephone_number": "630-300-0015",
            "fax_number": "630-300-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 LEGACY CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633161",
            "telephone_number": "630-300-0015",
            "fax_number": "630-300-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORSINI SURGICAL DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "ORSINI",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "PRIESS",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "630-300-0015"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• MOHS-Micrographic Surgery Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• MOHS-Micrographic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.