New York Dermatology & Mohs Surgery Group, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

205536 Issued in NY

Legal business name

NEW YORK DERMATOLOGY & MOHS SURGERY GROUP, PLLC

Practice address

225 W Montauk Hwy
Suite 3
Hampton Bays, NY 11946-3531

Phone

(631) 728-7288

Fax

(631) 728-4010

NPI assigned

Oct 24, 2008

Last updated

Mar 7, 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. Donna April Serure, D.O.

Title

Partner

Phone

(631) 543-4888

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• New York Dermatology & Skin Cancer Center Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• New York Dermatology & Mohs Surgery Group, PLLC

  • Dermatology Physician
  • Commack, NY
  • NPI 1851555122

  O20081210000771

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

New York Dermatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New York Dermatology & Mohs Surgery Group, PLLC

  • Dermatology Physician
  • Commack, NY
  • NPI 1851555122
  NPD tax ID

Locations

Practitioners 9

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.

• Noah Sol Gratch, MD

  • Dermatology Physician
  • New York, NY
  • NPI 1558380816
  NPD
• Lauren Penzi, M.D.

  • Dermatology Physician
  • Bethpage, NY
  • NPI 1720437536

  Single Specialty

  NPD
• Gregory Scott Phillips, MD

  • Dermatology Physician
  • New York, NY
  • NPI 1003442948

  Single Specialty

  NPD
• Kalee Shah, MD

  • MOHS-Micrographic Surgery Physician
  • Commack, NY
  • NPI 1922530443
  NPD
• Toral Vaidya, MD

  • Dermatology Physician
  • New York, NY
  • NPI 1588220776
  NPD
• Regina Yavel, M.D.

  • Dermatology Physician
  • Commack, NY
  • NPI 1871529016
  NPD
• Carolyn Stull, MD

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1881123073
  NPD
• Christos Zouzias

  • Dermatology Physician
  • Morristown, NJ
  • NPI 1598297434
  NPD
• Snehal P Amin, M.D.

  • Dermatology Physician
  • Smithtown, NY
  • NPI 1376585539
  NPD (past)

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1962655738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 100",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-4888",
            "fax_number": "631-543-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W MONTAUK HWY",
            "address_2": "SUITE 3",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119463531",
            "telephone_number": "631-728-7288",
            "fax_number": "631-728-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK DERMATOLOGY & MOHS SURGERY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SERURE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "APRIL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-543-4888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "205536",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "222859",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "215146",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "222859",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "215146",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "205536",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "222859",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "205536",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "222859",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Dermatology & Skin Cancer Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Meciko A Muharemovic, M.D.
• Shannon Marie Munday
• Denis Nankervis Jr., D.O.
• Jack Andrew Nelson, OMFS
• Catherine Nemazi-Hilton, MA,PT
• Trang Bichngoc Nguyen, D.O.
• Maryann Patricia Noble, RN
• Beverly Nogaro, R.N.
• Patricia Elizabeth Nunziata, RPA-C
• Andrea M Nydegger, LCSW

• Dermatology Physician in Hampton Bays, NY
• Providers in Hampton Bays, 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 Mar 7, 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.