Mariwalla Dermatology, PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

MARIWALLA DERMATOLOGY, PLLC

Practice address

1253 Montauk Hwy
West Islip, NY 11795-4916

Phone

(631) 665-3376

Fax

(631) 969-3376

NPI assigned

Mar 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kavita Mariwalla, MDNPI 1962674184

Title

Owner

Phone

(631) 665-3376

Specialties & licenses 1

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 10

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

• Kavita Mariwalla, M.D

  • MOHS-Micrographic Surgery Physician
  • West Islip, NY
  • NPI 1962674184
  Medicare reassignment Care Compare group NPD Authorized official
• Jeanne Marie Franck, M.D.

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1982671814
  Medicare reassignment Care Compare group NPD
• Meghan James, PA-C

  • Physician Assistant
  • West Islip, NY
  • NPI 1558145730
  Medicare reassignment Care Compare group
• Samantha Nicolini, RPA-C

  • Physician Assistant
  • West Islip, NY
  • NPI 1518340918
  Medicare reassignment Care Compare group
• Imara-Safi Olu Scott, MD

  • Dermatology Physician
  • Tallahassee, FL
  • NPI 1053801001

  NY

  Medicare reassignment NPD
• Kaleigh A Marino, RPA-C

  • Physician Assistant
  • Lynbrook, NY
  • NPI 1104069970
  Medicare reassignment
• Lauren Sulochana Mohan

  • Dermatology Physician
  • Glenview, IL
  • NPI 1457974123

  NY

  Medicare reassignment
• Paige E Spagna, DO

  • Dermatology Physician
  • New York, NY
  • NPI 1104447671

  Single Specialty

  NPD
• Jacquelyn Rubenstein, FNP-BC

  • Family Nurse Practitioner
  • Bay Shore, NY
  • NPI 1952983249
  NPD (past)
• Jacqueline Marie Schrom, PHYSICIAN ASSISTANT

  • Physician Assistant
  • West Islip, NY
  • NPI 1609606664
  NPD (past)

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1891094322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954916",
            "telephone_number": "631-665-3376",
            "fax_number": "631-969-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954916",
            "telephone_number": "631-665-3376",
            "fax_number": "631-969-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIWALLA DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "MARIWALLA",
        "authorized_official_first_name": "KAVITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-665-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Maresca, OTR/L
• Jeffrey Margulies, MD
• Kimberly Mariani, MS ED
• Christine Marijosius, PT
• Stephanie Cay Marinello
• Kavita Mariwalla, M.D
• Nitin Rajkumar Mariwalla, MD, MPH, MS
• Rajesh Mariwalla, MD
• Rajkumar G Mariwalla, M.D.
• Alyssa Marklin, NP

• MOHS-Micrographic Surgery Physician in West Islip, NY
• Providers in West Islip, 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 Apr 20, 2017; 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.