Individual provider Active NPI

Kautilya Shaurya, M.D., M.B.A

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1639598576
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
294708 Issued in NY
Practice address
217 Havemeyer St FL 5
Brooklyn, NY 11211
Phone
(212) 283-3000
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 294708 NY Primary

Addresses

Primary practice location

217 Havemeyer St FL 5
Brooklyn, NY 11211

Mailing address

2701 Queens PLZ N FL 10
Long Island City, NY 11101-4022
Phone (305) 585-1111

Other practice location 1

1611 NW 12th Ave
Central Building, Room 600D (R-60)
Miami, FL 33136-1005
Phone (305) 585-1111

Other practice location 2

153 E 88th St
New York, NY 10128-2270
Phone (212) 283-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181001001396 NY Practitioner - Dermatology 6406107416 Reassigns benefits to 1 organization
I20200612000250 FL Practitioner - Dermatology 6406107416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Howard University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians
Diagnostic and Clinical Care Services IncGroup PAC ID 4385645605, 5 clinicians

Practice addresses (Care Compare)

153 E 88TH St
New York, NY 10128-2270
Phone (212) 283-3000

2100 N Wickham Rd
Melbourne, FL 32935-8110
Phone (321) 752-7100

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision41
Removal of skin lesions198
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Doccs Inc CurrentSince May 20, 2020 Accepting new patients
Diagnostic and Clinical Care Services Inc Dermatology CurrentSince May 20, 2020 Accepting new patients

Locations

2100 N Wickham Rd
Melbourne, FL 32935
Phone (321) 254-4900

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1639598576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 QUEENS PLZ N FL 10",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014022",
            "telephone_number": "305-585-1111",
            "fax_number": "305-585-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 HAVEMEYER ST FL 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11211",
            "telephone_number": "212-283-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_2": "Central Building, Room 600D (R-60)",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-1111",
            "fax_number": "305-585-8137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 E 88th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101282270",
            "country_code": "US",
            "telephone_number": "212-283-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAURYA",
        "first_name": "KAUTILYA",
        "name_prefix": "Mr.",
        "credential": "M.D., M.B.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "294708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.