Lauren Elisabeth Cerullo, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01066538B Issued in IN

Practice address

9200 Calumet Ave
Ste 203
Munster, IN 46321-2885

Phone

(219) 228-4200

Fax

(844) 965-9457

NPI assigned

Oct 5, 2007

Last updated

Oct 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Rush Medical College of Rush University, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermio Dermatology LLCGroup PAC ID 7315206687, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Dermio Dermatology, LLC

  • Dermatology Physician
  • Munster, IN
  • NPI 1811402423
  Medicare reassignment Care Compare group NPD
• Dermio Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Munster, IN
  • NPI 1346072139
  NPD (past)
• Northern Indiana Dermatology and Skin Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Portage, IN
  • NPI 1639289093
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1144418914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 CALUMET AVE",
            "address_2": "STE 203",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212885",
            "telephone_number": "219-228-4200",
            "fax_number": "844-965-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 CALUMET AVE",
            "address_2": "STE 203",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212885",
            "telephone_number": "219-228-4200",
            "fax_number": "844-965-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERULLO",
        "first_name": "LAUREN",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01066538B",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A97206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Specialty Surgery
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• Centers for Pain Control Inc.
• Centers for Pain Control, Inc
• Cep America LLC
• Jennifer Lynn Cervantes
• Jin S Cha, MD
• Jorge Chahla, MD, PHD
• Indu Kumari Chalana, M.D.
• Chandrasekhlra Azad Challapalli, MD

• Dermatology Physician in Munster, IN
• Providers in Munster, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.