Atlantic Skin Surgery LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME66880 Issued in FL

Legal business name

ATLANTIC SKIN SURGERY LLC

Practice address

176 NW Magnolia Lakes Blvd
Port St Lucie, FL 34986-3567

Phone

(772) 828-1907

NPI assigned

Jul 23, 2012

Organization subpart

No

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

Authorized official

Name

Richard A James, M.D.NPI 1659387405

Title

Chief Operating Officer

Phone

(772) 828-1907

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Richard James, MD

  • Surgery Physician
  • Port St Lucie, FL
  • NPI 1659387405
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1942555289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 NW MAGNOLIA LAKES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863567",
            "telephone_number": "772-828-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 NW MAGNOLIA LAKES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863567",
            "telephone_number": "772-828-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC SKIN SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "772-828-1907",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME66880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Athanasatos
• Atlantic Care Home Health West Palm Beach LLC (Atlantic Care Services)
• Atlantic Coast Anesthesia Associates
• Atlantic Dental Management Company PA (Lucie Dental)
• Atlantic Isles Inpatient Services,LLC.
• Atlantic Spine of South Florida, LLC
• Vernon Thomas Atreidis, MD
• Anthony F Attanasio, LMHC, MCAP, QS
• Michael Anthony Attanasio, LMHC
• Joycelyne Augustin

• Surgery Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.