Skinpros LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKINPROS LLC

Practice address

1287 N Main St
Providence, RI 02904-1856

Phone

(401) 272-2724

Fax

(401) 272-2784

NPI assigned

Feb 5, 2012

Last updated

Dec 13, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Antonio Paulino Cruz, MDNPI 1063603553

Title

Owner/ Manager

Phone

(401) 243-3675

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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 14

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.

• Antonio P. Cruz, MD

  • MOHS-Micrographic Surgery Physician
  • Providence, RI
  • NPI 1063603553
  Medicare reassignment Care Compare group Authorized official
• Charbel Younes, FNP-BC

  • Family Nurse Practitioner
  • Bellingham, MA
  • NPI 1811568975

  RI

  Medicare reassignment Care Compare group NPD
• Stephen Cullen, PA-C

  • Physician Assistant
  • Lincoln, RI
  • NPI 1679838387
  Medicare reassignment Care Compare group
• Stephanie Dadario Lahaise I, PA

  • Physician Assistant
  • Cranston, RI
  • NPI 1740210509
  Medicare reassignment Care Compare group
• Haley McGrath, PA-C

  • Physician Assistant
  • Providence, RI
  • NPI 1316731102
  Medicare reassignment Care Compare group
• Caila Marie Nunes

  • Physician Assistant
  • Lincoln, RI
  • NPI 1922709245
  Medicare reassignment Care Compare group
• Radha Patel, PA

  • Physician Assistant
  • Providence, RI
  • NPI 1760171714
  Medicare reassignment Care Compare group
• Mark A Trott, PA

  • Physician Assistant
  • Providence, RI
  • NPI 1205892924
  Medicare reassignment Care Compare group
• Stephen Ernest Glinick, MD

  • Dermatology Physician
  • Providence, RI
  • NPI 1255337671
  Medicare reassignment NPD
• Katayun S Adhami, M.D.

  • MOHS-Micrographic Surgery Physician
  • Boston, MA
  • NPI 1679867766

  RI

  Medicare reassignment NPD
• Erik Domingues, MD

  • Dermatology Physician
  • Fall River, MA
  • NPI 1962713370

  RI

  Medicare reassignment NPD
• Deborah Paul, MD

  • MOHS-Micrographic Surgery Physician
  • Macedonia, OH
  • NPI 1700371960

  Dermatology, RI

  Medicare reassignment NPD

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

{
    "created_epoch": "1328400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1881966901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041856",
            "telephone_number": "401-272-2724",
            "fax_number": "401-272-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041856",
            "telephone_number": "401-272-2724",
            "fax_number": "401-272-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINPROS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-05",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "PAULINO",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "401-243-3675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Stasia Siwy, FNP-C
• Jon Joseph Skalecki, M.D.
• Kathryn A Skelly, MD
• Lauren A Skerritt, MS., OTR/L
• Dimitra Skiada
• Skinpros New England
• SKL Counseling, LLC
• Mitchel A Sklar, MD
• Luisa Skoble, MD
• Alexus Skobodzinski, MD

• Dermatology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Dermatology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.