Center for Skin Cancer Surgery, Inc.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME88079 Issued in FL

Legal business name

CENTER FOR SKIN CANCER SURGERY, INC.

Practice address

7960 N Wickham Rd
Suite 105
Melbourne, FL 32940

Phone

(321) 428-4545

Fax

(321) 421-7898

NPI assigned

Jul 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jeannine Stein, MDNPI 1407811235

Title

Owner

Phone

(321) 428-4545

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 7

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

• Jeannine Marie Stein, MD

  • MOHS-Micrographic Surgery Physician
  • Melbourne, FL
  • NPI 1407811235
  Medicare reassignment NPD Authorized official
• Shawn Marie Dague, ARNP, CNM

  • Advanced Practice Midwife
  • Merritt Island, FL
  • NPI 1245248871
  NPD (past)
• Vanessa Emily Johnson, M.D.

  • Dermatology Physician
  • Rockledge, FL
  • NPI 1972948875
  NPD (past)
• Eunice Sarah Mowery, PA-C

  • Medical Physician Assistant
  • Melbourne, FL
  • NPI 1558554501
  NPD (past)
• Shivani Patel, PA-C

  • Physician Assistant
  • Cocoa Beach, FL
  • NPI 1215379904
  NPD (past)
• Kathleen Verpaele, APRN

  • Nurse Practitioner
  • Melbourne, FL
  • NPI 1942446885
  NPD (past)
• Andrew Kelsey, MD

  • Dermatology Physician
  • Waterbury, CT
  • NPI 1649664731

  Mohs-Micrographic Surgery

  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1871900233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8057 SPYGLASS HILL RD",
            "address_2": "SUITE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408565",
            "telephone_number": "321-428-4545",
            "fax_number": "321-421-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 N WICKHAM RD",
            "address_2": "SUITE 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-428-4545",
            "fax_number": "321-421-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8057 Spyglass Hill Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329408565",
            "country_code": "US",
            "telephone_number": "321-428-4545",
            "fax_number": "321-421-7898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1223 Gateway Dr Ste 2H",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329012607",
            "country_code": "US",
            "telephone_number": "321-361-5606",
            "fax_number": "321-751-9362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7125 Murrell Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329407999",
            "country_code": "US",
            "telephone_number": "321-361-5606",
            "fax_number": "321-751-9362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR SKIN CANCER SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-428-4545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME88079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFMG MA",
            "identifier": "RH580",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• MOHS-Micrographic Surgery Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.