Elevate Dermatology, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ELEVATE DERMATOLOGY, P.C.

Practice address

66 Commack Rd Ste 200
Commack, NY 11725-3405

Phone

(631) 481-7470

Fax

(631) 623-1623

NPI assigned

Jul 25, 2023

Last updated

Nov 19, 2023By 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. Tamara Koss, MDNPI 1013989599

Title

President

Phone

(917) 575-5306

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 1

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.

• Tamara Koss, MD

  • Dermatology Physician
  • Smithtown, NY
  • NPI 1013989599
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700352000000",
    "number": "1932880788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 COMMACK RD STE 200",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253405",
            "telephone_number": "631-481-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 COMMACK RD STE 200",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253405",
            "telephone_number": "631-481-7470",
            "fax_number": "631-623-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A",
        "authorized_official_last_name": "KOSS",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-575-5306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Christopher Edwards, LMSW
• Jennifer Ann Egan, M.A.
• Jennifer Ehlers, DO
• Noelle Eichenlaub
• Daryle A Eisner I, MSED
• Janice D. Elgort-Dubroff, MS CCC SLP
• Adrienne Elliot
• Meghan Els
• Lisa Beth Emord
• Empirical Medical and Wellness Center LLC

• Dermatology Physician in Commack, NY
• Providers in Commack, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.