Visage Dermatology, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME83035 Issued in FL

Legal business name

VISAGE DERMATOLOGY, LLC

Practice address

5253 Central Ave
St Petersburg, FL 33710-8141

Phone

(727) 388-6982

NPI assigned

Sep 25, 2006

Last updated

Jul 17, 2008By 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

Alexandria Kongsiri, M.D.NPI 1740275791

Title

Physician

Phone

(727) 388-6982

Specialties & licenses 1

Addresses

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 12

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.

• Alexandria S. Kongsiri, M.D.

  • Dermatology Physician
  • St Petersburg, FL
  • NPI 1740275791
  Medicare reassignment Care Compare group NPD Authorized official
• Sergey Arutyunyan, D.O.

  • Dermatology Physician
  • South Miami, FL
  • NPI 1295274843
  Medicare reassignment Care Compare group NPD
• Christina Greene, APRN

  • Family Nurse Practitioner
  • St Petersburg, FL
  • NPI 1689202426
  Medicare reassignment Care Compare group NPD
• Vishnu Harikumar, MD

  • Dermatology Physician
  • St Petersburg, FL
  • NPI 1164009726
  Medicare reassignment Care Compare group NPD
• Rebecca Mahne

  • Physician Assistant
  • Lakewood Ranch, FL
  • NPI 1780152645
  Medicare reassignment Care Compare group NPD
• James Montgomery Spencer, M.D.

  • Dermatology Physician
  • Palmetto, FL
  • NPI 1730102385

  Specialist

  Medicare reassignment Care Compare group NPD
• Keischa N Cash, DNP, APRN, FNP-BC

  • Nurse Practitioner
  • Plant City, FL
  • NPI 1235380940
  Medicare reassignment NPD
• Jessin Helmrick-Blossom, M.D.

  • MOHS-Micrographic Surgery Physician
  • Ocala, FL
  • NPI 1265661680

  Dermatology

  Medicare reassignment NPD
• Gail Viora Smith, APRN

  • Family Nurse Practitioner
  • St Petersburg, FL
  • NPI 1053374009
  Medicare reassignment NPD
• Randy Tang, MD

  • Dermatology Physician
  • St Petersburg, FL
  • NPI 1285928275

  Single Specialty

  Medicare reassignment NPD
• Amanda Smay, PA-C

  • Physician Assistant
  • Clearwater, FL
  • NPI 1467102541
  Medicare reassignment
• Amy L Horner, PA-C

  • Medical Physician Assistant
  • Saint Joseph, MO
  • NPI 1164430740

  FL

  Medicare reassignment

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1932200045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5253 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108141",
            "telephone_number": "727-388-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108141",
            "telephone_number": "727-388-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISAGE DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "KONGSIRI",
        "authorized_official_first_name": "ALEXANDRIA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-388-6982",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME83035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vip Eye Care and Eye Wear Inc
• Vip Eye Care and Optical Boutique at Carillon LLC
• Vip Surgery Center-St Petersburg LLC
• Sehrish Viqar
• Madhukar Mahadeo Virkud, OTR/L
• Michael Viscusi
• Vision Specialty Associates, P.a.
• Vision Specialty Associates, P.a. (Vision Specialty Assoc., P.a. #07)
• Visionary Virtual Healthcare, LLC
• Visionworks Inc (Visionworks)

• Specialist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.