Individual provider Active NPI

Shery Mathew Varghese, M.D.

  • Dermatology Physician
  • Palm Bay, FL
National Provider Identifier
1154584084
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME133190 Issued in FL
Practice address
1761 Palm Bay Rd NE
Palm Bay, FL 32905-2902
Phone
(321) 220-6400
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD443020 PA
Dermatology Physician 207N00000X ME133190 FL Primary

Addresses

Primary practice location

1761 Palm Bay Rd NE
Palm Bay, FL 32905-2902

Mailing address

2845 Pga Blvd
Palm Beach Gardens, FL 33410-2910
Phone (561) 693-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20121008000047 FL Practitioner - DermatologyPractitioner - Pathology 6002085941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

3659 S Miami Ave
Suite 6008
Miami, FL 33133-4221
Phone (305) 856-6555

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision81
Removal of skin lesions995
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD443020PAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Water'S Edge Dermatology, LLC CurrentSince Dec 1, 2017 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients
Aqua Dermatology of Florida, PA Dermatology CurrentSince Jan 1, 2022 Accepting new patients
Florida Dermatology Associates Inc CurrentSince Oct 1, 2012 Accepting new patients
Water'S Edge Dermatology, LLC Dermatology CurrentSince Dec 1, 2017 Accepting new patients

Locations

80 Woodland Ave
Cocoa Beach, FL 32931
Phone (321) 768-1600

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

5070 Minton Rd NW
Ste 5
Palm Bay, FL 32907
Phone (321) 768-1600

5070 Minton Rd NW
Ste 3A
Palm Bay, FL 32907

590 Malabar Rd SE
Ste 2
Palm Bay, FL 32907
Phone (321) 220-6400

5070 Minton Rd NW
#3A
Palm Bay, FL 32907

1761 Palm Bay Rd NE
Palm Bay, FL 32905
Phone (321) 220-6400

600 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

264 NW Peacock Blvd
St Lucie West, FL 34986
Phone (772) 208-8800

3745 11th Cir
Ste 107
Vero Beach, FL 32960
Phone (772) 562-2330

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: svarghese@aquadermatology.emadirect.md

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1154584084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102910",
            "telephone_number": "561-693-0540",
            "fax_number": "561-422-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 PALM BAY RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052902",
            "telephone_number": "321-220-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "SHERY",
        "middle_name": "MATHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD443020",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME133190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.