NPIMap

Individual provider Active NPI

Luis E Berrutti, M.D.

  • Dermatopathology (Pathology) Physician
  • Port Washington, NY
National Provider Identifier
1962548438
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
200021-1 Issued in NY
Practice address
2 N Plandome Rd
Port Washington, NY 11050-3443
Phone
(516) 944-3882
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 200021-1 NY Primary

Addresses

Primary practice location

2 N Plandome Rd
Port Washington, NY 11050-3443

Mailing address

PO Box 1152
Huntington, NY 11743-0656
Phone (516) 398-5190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100518000550 NY Practitioner - Pathology 6103955802 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roger Koreen M.D., PCGroup PAC ID 9537161161, 5 clinicians

Practice addresses (Care Compare)

28 Elm St
Huntington, NY 11743-3402
Phone (631) 421-4398

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200021-1NYMDDermatopathology (Pathology) Physician

Practice roles (10 of 14)

OrganizationSpecialtyStatusNew patients
Belaray Dermatology PC CurrentSince Dec 15, 2013 Accepting new patients
Bodian Dermatology Group, P.C CurrentSince Sep 1, 2015 Accepting new patients
Huntington Dermatology and Cosmetics Associate PC CurrentSince Apr 24, 2012 Accepting new patients
Dr Donna a Serure, Dermatology & Cosmetic Laser Surgery, PC CurrentSince Oct 1, 2018 Accepting new patients
Columbia Presbyterian Pathologists Dermatopathology Past Accepting new patients
Pathology Solutions LLC Past Accepting new patients
Austin FP PastSince Oct 26, 2017 Accepting new patients
Laboratory of Dermatopathology Adx, LLC Dermatopathology PastSince Jul 4, 2026 Accepting new patients
Bodian Medical Services of Forest Hills PC PastSince Sep 1, 2015 Accepting new patients
Laserderm Dermatology & Cosmetic Laser Surgery PastSince Oct 1, 2018 Accepting new patients

Locations

11 Grace Ave
Ste 100
Great Neck, NY 11021
Phone (516) 482-2882

358 S Oyster Bay Rd
Hicksville, NY 11801
Phone (516) 488-7546

200 W Carver St
Ste 2
Huntington, NY 11743
Phone (631) 424-3376

327 E Middle Country Rd
Smithtown, NY 11787
Phone (631) 979-0909

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1962548438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1152",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117430656",
            "telephone_number": "516-398-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N PLANDOME RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503443",
            "telephone_number": "516-944-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRUTTI",
        "first_name": "LUIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NY",
            "license": "200021-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.