Charisse McCall, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

260162 Issued in NY

Practice address

149 Commack Rd
Ste B
Commack, NY 11725-3459

Phone

(631) 467-4653

NPI assigned

Apr 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00140

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gold Coast Dermatology PC

  • Dermatology Physician
  • Commack, NY
  • NPI 1578138343
  Medicare reassignment NPD Authorized official
• Belaray Dermatology PC

  • Dermatology Physician
  • Hicksville, NY
  • NPI 1225237886
  Medicare reassignment NPD

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1073802450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 COMMACK RD STE B",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253459",
            "telephone_number": "631-467-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 COMMACK RD",
            "address_2": "STE B",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253459",
            "telephone_number": "631-467-4653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "358 S Oyster Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "NY",
            "postal_code": "118013508",
            "country_code": "US",
            "telephone_number": "516-822-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "CHARISSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "260162",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "260162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03918898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Robin Mayo, M.S.
• Britta Kareen Mazur, DO
• Dominika Mazur, LPN
• Christina Mazza I, SPEECH PATHOLOGIST
• Kathleen Mary McCabe, B.A.
• Susan Christine McCormack, M.A., CCC-SLP
• Kerry A McCormick, PTA
• Alyssa McCoun, MS CCC-SLP TSSLD
• Maria Regina McCutcheon, PTA
• Kathy Ann McDermott, RNMSNPP

• Dermatology Physician in Commack, NY
• Providers in Commack, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.