Randolph Dermatology and Mohs Micrographic Surgery LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

25MA07842 Issued in NJ

Legal business name

RANDOLPH DERMATOLOGY AND MOHS MICROGRAPHIC SURGERY LLC

Practice address

390 Route 10 W
Suite 102
Randolph, NJ 07869-2141

Phone

(973) 366-6303

Fax

(973) 891-1505

NPI assigned

May 6, 2008

Organization subpart

No

Name

David Najarian, MDNPI 1760694038

Title

Owner

Phone

(732) 309-2016

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

• David James Najarian, MD

  • MOHS-Micrographic Surgery Physician
  • Randolph, NJ
  • NPI 1760694038

  Mohs-Micrographic Surgery, NJ

  Medicare reassignment Care Compare group NPD Authorized official
• Carlos Martinez, PA

  • Physician Assistant
  • Randolph, NJ
  • NPI 1649895160

  NJ

  Medicare reassignment Care Compare group
• Alyssa C Townsend, PA-C

  • Medical Physician Assistant
  • Whippany, NJ
  • NPI 1447011010

  NJ

  Medicare reassignment NPD

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

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 30, 2011.

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1497921738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 ROUTE 10 W",
            "address_2": "SUITE 102",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692141",
            "telephone_number": "973-366-6303",
            "fax_number": "973-891-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 ROUTE 10 W",
            "address_2": "SUITE 102",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692141",
            "telephone_number": "973-366-6303",
            "fax_number": "973-891-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH DERMATOLOGY AND MOHS MICROGRAPHIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "NAJARIAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-309-2016",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NJ",
            "license": "25MA07842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nishan George Rajaratnam, MD
• Melissa Randazzo, MD
• Randolph Center for Oral and Maxillofacial Surgery, LLC
• Randolph Center for Oral and Maxillofacial Surgery, PA
• Randolph Dental Care
• Randolph Eyecare Center PA
• Randolph Family & Cosmetic Dentistry
• Randolph Family Hearing Center
• Randolph Medical & Renal Associates P.a.
• Randolph Oral Pathology Associates, LLC

• All providers in Randolph, NJ
• MOHS-Micrographic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.