Active NPI
Colleen Mary Crandell, D.O.
- Dermatology Physician
- Vestal, NY
National Provider Identifier
1144269176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 227706
- Practice address
- 200 Plaza Dr
Suite B
Vestal, NY 13850-3680 - Phone
- (607) 729-2777
- NPI assigned
- Jun 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 227706 | NY | Primary |
Addresses
Primary practice location
200 Plaza Dr
Suite B
Vestal, NY 13850-3680
Mailing address
25 Deborah Dr
Johnson City, NY 13790-5102
Phone (607) 729-0779
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- New York Medical College, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
333 Hooper Rd
Endwell, NY 13760-3641
Phone (212) 283-3000
Hospital & facility affiliations
- Our Lady of Lourdes Memorial Hospital, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.15 of 100
- Promoting interoperability
- 99
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 129 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 403 |
| Removal of skin cancer | 91 |
| Removal or shaving of skin growth | 123 |
| Skin biopsy | 101 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantic Dermatologic Associates, LLP | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Organizations & group practices 2
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.
-
- Dermatology Physician
- New York, NY
- NPI 1831438662
-
- Specialist
- Lynbrook, NY
- NPI 1447264387
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1629087580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1144269176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 DEBORAH DR",
"city": "JOHNSON CITY",
"state": "NY",
"postal_code": "137905102",
"telephone_number": "607-729-0779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PLAZA DR",
"address_2": "SUITE B",
"city": "VESTAL",
"state": "NY",
"postal_code": "138503680",
"telephone_number": "607-729-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDELL",
"first_name": "COLLEEN",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "227706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.