SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
NPI 1770770547
Dermatology - MOHS-Micrographic Surgery in Providence, RI
NPI Status: Active since September 26, 2007
Contact Information
1 RANDALL SQ
SUITE 306
PROVIDENCE, RI
ZIP 02904
Phone: (401) 751-7546
Fax: (401) 751-6888
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- Accepts Insurance
- CLIA Number: 22D2103343
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-15-2026
About SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
This page provides the complete NPI Profile along with additional information for Surgical & Cosmetic Dermatology Of Rhode Island, Llc, a provider established in Providence, Rhode Island operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1770770547 assigned on September 2007. The practitioner's primary taxonomy code is 207ND0101X with license number MD10753 (RI). The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Marina Kuperman-beade M.d. (Owner)
- NPI
- 1770770547
- Provider Name
- SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
- Entity Type
- Organization
- Location Address
- 1 RANDALL SQ SUITE 306 PROVIDENCE, RI 02904
- Location Phone
- (401) 751-7546
- Location Fax
- (401) 751-6888
- Mailing Address
- 1 RANDALL SQ SUITE 306 PROVIDENCE, RI 02904
- Mailing Phone
- (401) 751-7546
- Mailing Fax
- (401) 751-6888
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-26-2007
- Last Update Date
- 03-04-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD10753
- License State
- RI
- Taxonomy Description
- The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| DD6437 | OTHER (01) | RI | RAILROAD MEDICARE |
| 9003758 | MEDICAID (05) | RI | |
| 709003758 | MEDICARE PIN (08) | RI | |
| H15417 | MEDICARE UPIN (02) | RI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 22D2103343
- Facility Type
- Physician Office
- Certificate Effective Date
- February 16, 2024
- Certificate Expiration Date
- February 15, 2026
- Laboratory Director
- MARINA KUPERMAN-BEADE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Surgical & Cosmetic Dermatology Of Rhode Island, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 7 | 0 | 7 | 7 | 0 | 5 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 14 | 0 | 14 | 7 | 0 | 5 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 4 + 0 + 1 + 4 + 7 + 0 + 5 + 8 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1770770547 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1245229764 | DONALD GEORGE KAUFMAN M.D. Individual | Internal Medicine | 1 RANDALL SQ SUITE 305 PROVIDENCE, RI 02904 (401) 274-4800 |
| 1083683148 | PAUL W WEHBE MD Individual | Pediatrics | 1 RANDALL SQ SUITE 404-406 PROVIDENCE, RI 02904 (401) 861-5183 |
| 1548228794 | SOUTHERN NEW ENGLAND RETINA ASSOCIATES, PC Organization | Ophthalmology | 1 RANDALL SQ SUITE 203 PROVIDENCE, RI 02904 (401) 453-4600 |
| 1790731396 | DR. ABIDA KHALIL SATTAR Individual | Surgery | 1 RANDALL SQ SUITE 406 PROVIDENCE, RI 02904 (404) 421-2928 |
| 1669492070 | LUCIANO SZTULMAN MD Individual | Obstetrics & Gynecology | 1 RANDALL SQ SUITE 401 PROVIDENCE, RI 02904 (401) 521-1006 |
| 1689695736 | DR. ANTHONY LE ROY MOULTON MD Individual | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 RANDALL SQ STE 414 PROVIDENCE, RI 02904 (401) 331-4175 |
| 1588685754 | LUCIANO SZTULMAN MD INC Organization | Obstetrics & Gynecology | 1 RANDALL SQ SUITE 401 PROVIDENCE, RI 02904 (401) 521-1006 |
| 1588673065 | ELISE ROSENBERG SU MD Individual | Obstetrics & Gynecology | 1 RANDALL SQ PROVIDENCE, RI 02904 (401) 331-6980 |
| 1467533364 | DR. RAZI HASAN M.D. Individual | Pediatrics | 1 RANDALL SQ SUITE 404 PROVIDENCE, RI 02904 (401) 861-5183 |
| 1316017874 | PROVIDENCE CARDIOLOGY TESTING Organization | Internal Medicine (Cardiovascular Disease) | 1 RANDALL SQ SUITE 305 PROVIDENCE, RI 02904 (401) 521-0700 |
| 1790856888 | PROVIDENCE CARDIOLOGY INC Organization | Internal Medicine (Cardiovascular Disease) | 1 RANDALL SQ SUITE 305 PROVIDENCE, RI 02904 (401) 521-0700 |
| 1992876080 | MR. JACK H KLIE MD Individual | Internal Medicine (Cardiovascular Disease) | 1 RANDALL SQ SUITE 305 PROVIDENCE, RI 02904 (401) 521-0700 |
| 1447305636 | JEFFREY WISHIK MD Individual | Psychiatry & Neurology (Neurology) | 1 RANDALL SQ SUITE 409 PROVIDENCE, RI 02904 (401) 274-5150 |
| 1669654711 | MARLENE CUTITAR,MD,LLC Organization | Specialist | 1 RANDALL SQ SUITE 402 PROVIDENCE, RI 02904 (401) 273-5441 |
| 1235315284 | SUNSHINE PEDIATRICS LLC Organization | Pediatrics | 1 RANDALL SQ SUITE 404-406 PROVIDENCE, RI 02904 (401) 861-5183 |
| 1992944078 | SONOTEC IMAGING INC. Organization | Clinical Medical Laboratory | 1 RANDALL SQ SUITE 307 PROVIDENCE, RI 02904 (508) 567-4241 |
| 1396040242 | ANN LHEUREUX RN Individual | Registered Nurse (Diabetes Educator) | 1 RANDALL SQ PROVIDENCE, RI 02904 (401) 331-6980 |
| 1255639225 | RENEE R EGER MD LLC Organization | Obstetrics & Gynecology (Gynecology) | 1 RANDALL SQ SUITE 205 PROVIDENCE, RI 02904 (401) 331-6980 |
| 1609169150 | BENJAMIN VOGEL, MD, LLC Organization | Obstetrics & Gynecology | 1 RANDALL SQ SUITE 205 PROVIDENCE, RI 02904 (401) 331-6980 |
| 1073807764 | DR. JAMES J YASHAR M.D Individual | Specialist | 1 RANDALL SQ PROVIDENCE, RI 02904 (140) 196-5777 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770770547, enumerated in the NPI registry as an "organization" on September 26, 2007
The provider is located at 1 Randall Sq Suite 306 Providence, Ri 02904 and the phone number is (401) 751-7546
This medical organization specializes in Dermatology with taxonomy code 207ND0101X with a focus in MOHS-Micrographic Surgery
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Railroad. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 22D2103343 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on September 26, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.