Organization Active NPI

Carlos a Charles MD PC

Doing business as Derma di Colore

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1144574500
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
220104 Issued in NY
Legal business name
CARLOS A CHARLES MD PC
Doing business as
Derma di Colore
Practice address
115 W 27TH St
Suite 1001
New York, NY 10001-6217
Phone
(347) 889-5413
NPI assigned
Nov 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Authorized official

Name
Dr. Carlos A Charles, MD
Title
Owner
Phone
(217) 889-5413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 220104 NY Primary

Addresses

Primary practice location

115 W 27TH St
Suite 1001
New York, NY 10001-6217

Mailing address

115 W 27TH St
Suite 1001
New York, NY 10001-6217
Phone (347) 889-5413

Other names 1

  • Derma di Colore Doing business as

National Provider Directory

National Provider Directory

Locations

115 W 27th St
Ste 1001
New York, NY 10001
Phone (212) 243-6700

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1144574500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 27TH ST",
            "address_2": "SUITE 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016217",
            "telephone_number": "347-889-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 27TH ST",
            "address_2": "SUITE 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016217",
            "telephone_number": "347-889-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS A CHARLES MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-889-5413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "220104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derma di Colore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.