Sunwise Dermatology & Surgery LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

2017605796 Issued in DE

Legal business name

SUNWISE DERMATOLOGY & SURGERY LLC

Practice address

102 Sleepy Hollow Dr Ste 203
Middletown, DE 19709-5841

Phone

(856) 816-2934

NPI assigned

Aug 15, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Larusso, DONPI 1932360906

Title

Owner

Phone

(856) 816-2934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Jennifer Lynn Larusso, D.O.

  • MOHS-Micrographic Surgery Physician
  • Marlton, NJ
  • NPI 1932360906

  DE

  Medicare reassignment Care Compare group NPD Authorized official
• Stacie Guyton, NP

  • Nurse Practitioner
  • Newark, DE
  • NPI 1518574490
  Medicare reassignment Care Compare group NPD
• Gerard W Stroup, PA-C

  • Physician Assistant
  • Middletown, DE
  • NPI 1730195058
  Medicare reassignment Care Compare group
• Nicole C Stroup, P.A

  • Physician Assistant
  • Linwood, NJ
  • NPI 1649472358

  DE

  Medicare reassignment Care Compare group
• Gina M Caputo, DO

  • Dermatology Physician
  • Newark, DE
  • NPI 1124464201
  Medicare reassignment NPD
• Chandni Patel

  • Nurse Practitioner
  • Middletown, DE
  • NPI 1790322345
  Medicare reassignment NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386160059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SLEEPY HOLLOW DR STE 203",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095841",
            "telephone_number": "856-816-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SLEEPY HOLLOW DR STE 203",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095841",
            "telephone_number": "856-816-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNWISE DERMATOLOGY & SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LARUSSO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-816-2934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "DE",
            "license": "2017605796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Sturgis
• Vidyarani Subbaraya, M.D.
• Caitlyn Suchanic, FNP
• Summit Dental P.a.
• Suncoast Medical Group LLC
• Superior Medical Transportation Inc
• Supportive Healing Counseling Services, LLC
• Desiree Aline Surguy, FNP-C
• Agnes Khalid Adel Sweileh, RPH
• Rodrigo Cordero Tanchanco, MD

• MOHS-Micrographic Surgery Physician in Middletown, DE
• Providers in Middletown, DE by specialty
• MOHS-Micrographic Surgery Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.