Carolin T Penrose, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

245597 Issued in NY

Practice address

1110 South Ave
Suite 400
Staten Island, NY 10314-3411

Phone

(917) 830-1415

Fax

(917) 830-1418

NPI assigned

Jun 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carolin Suarez Former name

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Dermatology

Education

New York Medical College, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• Penrose Dermatology PLLC

  • Medical Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1346601333
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1790946655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SOUTH AVE",
            "address_2": "SUITE 400",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143411",
            "telephone_number": "917-830-1415",
            "fax_number": "917-830-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SOUTH AVE",
            "address_2": "SUITE 400",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143411",
            "telephone_number": "917-830-1415",
            "fax_number": "917-830-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROSE",
        "first_name": "CAROLIN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "245597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLIN",
            "last_name": "SUAREZ",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Pennacchio, RN
• Louise Pennington
• Viviene Pennington, LMSW
• Mya Pauline Pennisi, MS, OTR/L
• Penrose Dermatology PLLC
• Mary Pensabene, RPH
• Rosa Pensabene
• Tetyana Pensabene
• People's Choice Pharmacy Ny Corp
• People's Path Inc.

• Dermatology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.