Organization Active NPI

Skin Specialists of the Capital Region, PLLC

  • MOHS-Micrographic Surgery Physician
  • Albany, NY
National Provider Identifier
1346437092
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
1823931 Issued in NY
Legal business name
SKIN SPECIALISTS OF THE CAPITAL REGION, PLLC
Practice address
264 Washington Avenue Ext Ste 201
Suite 201
Albany, NY 12203-6352
Phone
(518) 452-1928
Fax
(518) 708-8749
NPI assigned
Sep 26, 2007
Last updated
Jun 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Authorized official

Name
Christy Arsenault
Title
Practice Manager
Phone
(518) 452-1928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X 1823931 NY Primary

Addresses

Primary practice location

264 Washington Avenue Ext Ste 201
Suite 201
Albany, NY 12203-6352

Mailing address

264 Washington Avenue Ext Ste 201
Albany, NY 12203-6352
Phone (518) 452-1928

Other identifiers 1

IdentifierTypeStateIssuer
1823931OtherNYNYS LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624001064 NY Part B Supplier - Clinic/Group Practice 5597741371 Receives reassigned benefits from 16 practitioners
Practice locations: Albany, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0684091Skin Specialists of the Capital Region PLLC264 Washington Extension, Suite 201, Albany, NY 12203ComplianceJun 29, 2027

National Provider Directory

National Provider Directory

Locations

264 Washington Avenue Ext
Albany, NY 12203
Phone (518) 452-1928

264 Washington Avenue Ext
Ste 201
Albany, NY 12203
Phone (518) 452-1928

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1346437092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 WASHINGTON AVENUE EXT STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122036352",
            "telephone_number": "518-452-1928",
            "fax_number": "518-362-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 WASHINGTON AVENUE EXT STE 201",
            "address_2": "SUITE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122036352",
            "telephone_number": "518-452-1928",
            "fax_number": "518-708-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN SPECIALISTS OF THE CAPITAL REGION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "ARSENAULT",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "518-452-1928"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "1823931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "1823931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.