Organization Active NPI

Cosmetic Surgery and Derm, PLLC

  • Physician Assistant
  • New York, NY
National Provider Identifier
1780086678
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018002 Issued in NY
Legal business name
COSMETIC SURGERY AND DERM, PLLC
Practice address
117 E 18TH St
Suite 1
New York, NY 10003-2113
Phone
(212) 673-5633
NPI assigned
Sep 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Authorized official

Name
Dr. Omar Torres, M.D.
Title
Medical Director
Phone
(212) 673-5633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X 018002 NY Primary

Addresses

Primary practice location

117 E 18TH St
Suite 1
New York, NY 10003-2113

Mailing address

117 E 18TH St
Suite 1
New York, NY 10003-2113
Phone (212) 673-5633

Other identifiers 1

IdentifierTypeStateIssuer
WER941OtherNYMEDICAREGROUP

Other names 1

  • DermgroupNYC Other name

National Provider Directory

National Provider Directory

Locations

117 E 18th St
Frnt 1
New York, NY 10003
Phone (212) 673-5633

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1780086678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E 18TH ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032113",
            "telephone_number": "212-673-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E 18TH ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032113",
            "telephone_number": "212-673-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC SURGERY AND DERM, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-673-5633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAREGROUP",
            "identifier": "WER941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DermgroupNYC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.