Rochester Dermatologic Surgery PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

ROCHESTER DERMATOLOGIC SURGERY PC

Practice address

7400 Pittsford Victor Rd
Victor, NY 14564-9725

Phone

(585) 222-1400

Fax

(585) 222-1414

NPI assigned

May 13, 2019

Organization subpart

No

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

Authorized official

Name

Sherrif F Ibrahim, MDNPI 1508975731

Title

Owner

Phone

(206) 915-3484

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 8

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

• Sherrif F Ibrahim, MD

  • MOHS-Micrographic Surgery Physician
  • Victor, NY
  • NPI 1508975731

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Daniel P Bax, MD

  • Dermatology Physician
  • Lockport, NY
  • NPI 1598254005
  Medicare reassignment Care Compare group NPD
• Alexandra Murray Bender, MD, PHD

  • Dermatology Physician
  • Victor, NY
  • NPI 1689063513
  Medicare reassignment Care Compare group NPD
• Kelly Jordan Demchuk, NP

  • Family Nurse Practitioner
  • Victor, NY
  • NPI 1790297513
  Medicare reassignment Care Compare group NPD
• William Sipprell III, M.D.

  • MOHS-Micrographic Surgery Physician
  • Victor, NY
  • NPI 1699182881

  Dermatology

  Medicare reassignment Care Compare group NPD
• Jennifer N Tantalo, RPA-C

  • Physician Assistant
  • Rochester, NY
  • NPI 1942279666
  Medicare reassignment Care Compare group
• Desiree Ratner, M.D.

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1548360795

  Dermatology

  Medicare reassignment NPD
• Maria Christine Costello, PA-C

  • Physician Assistant
  • Rochester, NY
  • NPI 1619574209
  Medicare reassignment

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1770149080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 PITTSFORD VICTOR RD",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 PITTSFORD VICTOR RD",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649725",
            "telephone_number": "585-222-1400",
            "fax_number": "585-222-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHESTER DERMATOLOGIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SHERRIF",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-915-3484",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Marie Ridout
• Sofia Riffaud
• Rebecca Morgan Robel, PT
• Robert M. Biernbaum, D.O., P.C.
• Sophie Roberts
• Christie Ann Rochester
• Rena J Rodwell
• Linda S Rogers, M.A.
• Wendy Rogers
• Monica Renee Rohr, RN

• MOHS-Micrographic Surgery Physician in Victor, NY
• Providers in Victor, NY by specialty
• MOHS-Micrographic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.