NPIMap

Organization Active NPI

Dr Donna a Serure, Dermatology & Cosmetic Laser Surgery, PC

  • Dermatology Physician
  • Smithtown, NY
National Provider Identifier
1902959893
Registry record updated Feb 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DR DONNA A SERURE, DERMATOLOGY & COSMETIC LASER SURGERY, PC
Practice address
327 E Main St
Smithtown, NY 11787-2905
Phone
(631) 979-0909
Fax
(631) 979-0455
NPI assigned
Jan 22, 2007
Last updated
Feb 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2018

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

Authorized official

Name
David A. Serure
Title
Ceo
Phone
(631) 271-1035

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU
Dermatopathology Physician 207ND0900X 146291-1 NY
Pediatric Dermatology Physician 207NP0225X NU
Procedural Dermatology Physician 207NS0135X NU

Addresses

Primary practice location

327 E Main St
Smithtown, NY 11787-2905

Mailing address

327 E Main St
Smithtown, NY 11787-2905
Phone (631) 979-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311001381 NY Part B Supplier - Clinic/Group Practice 5991694564 Receives reassigned benefits from 7 practitioners
Practice locations: Smithtown, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518307200000",
    "number": "1902959893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872905",
            "telephone_number": "631-979-0909",
            "fax_number": "631-385-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872905",
            "telephone_number": "631-979-0909",
            "fax_number": "631-979-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DONNA A SERURE, DERMATOLOGY & COSMETIC LASER SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-02-11",
        "status": "A",
        "authorized_official_last_name": "SERURE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-271-1035"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": "146291-1",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.