Organization Active NPI

Comprehensive Dermatology of Rochester, PLLC

  • Dermatology Physician
  • Pittsford, NY
National Provider Identifier
1710235536
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2424371 Issued in NY
Legal business name
COMPREHENSIVE DERMATOLOGY OF ROCHESTER, PLLC
Practice address
135 Sullys TRL
Suite 7
Pittsford, NY 14534-4564
Phone
(585) 381-5800
Fax
(585) 348-9461
NPI assigned
Aug 28, 2012
Last updated
May 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Dr. Manasi Kadam Ladrigan, MDNPI 1366457814
Title
Physician
Phone
(585) 381-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2424371 NY Primary

Addresses

Primary practice location

135 Sullys TRL
Suite 7
Pittsford, NY 14534-4564

Mailing address

135 Sullys TRL
Suite 7
Pittsford, NY 14534-4564
Phone (585) 381-5800

Other identifiers 1

IdentifierTypeStateIssuer
J100078800OtherNYMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120918000276 NY Part B Supplier - Clinic/Group Practice 3971751801 Receives reassigned benefits from 4 practitioners
Practice locations: Pittsford, NY

National Provider Directory

National Provider Directory

Locations

135 Sullys Trl
Ste 7
Pittsford, NY 14534
Phone (585) 381-5800

141 Sullys Trl
Ste 11
Pittsford, NY 14534
Phone (585) 381-5800

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1710235536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SULLYS TRL",
            "address_2": "SUITE 7",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344564",
            "telephone_number": "585-381-5800",
            "fax_number": "585-348-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SULLYS TRL",
            "address_2": "SUITE 7",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344564",
            "telephone_number": "585-381-5800",
            "fax_number": "585-348-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE DERMATOLOGY OF ROCHESTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "LADRIGAN",
        "authorized_official_first_name": "MANASI",
        "authorized_official_middle_name": "KADAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "585-381-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "2424371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J100078800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.