SUNCOAST DERMATOLOGY AND SKIN SURGERY CENTER, PA
NPI 1902890239
Dermatology in Lecanto, FL
NPI Status: Active since September 01, 2005
Contact Information
525 N DACIE PT
LECANTO, FL
ZIP 34461
Phone: (352) 746-2200
Fax: (352) 746-9320
- Organization
- Dermatology
- Accepts Insurance
- CLIA Number: 10D0272561
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-29-2026
About SUNCOAST DERMATOLOGY AND SKIN SURGERY CENTER, PA
This page provides the complete NPI Profile along with additional information for Suncoast Dermatology And Skin Surgery Center, Pa, a provider established in Lecanto, Florida operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1902890239 assigned on September 2005. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 14 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. Ralph Eugene Massullo Jr. Md (President)
- NPI
- 1902890239
- Provider Name
- SUNCOAST DERMATOLOGY AND SKIN SURGERY CENTER, PA
- Entity Type
- Organization
- Location Address
- 525 N DACIE PT LECANTO, FL 34461
- Location Phone
- (352) 746-2200
- Location Fax
- (352) 746-9320
- Mailing Address
- 525 N DACIE PT LECANTO, FL 34461
- Mailing Phone
- (352) 746-2200
- Mailing Fax
- (352) 746-9320
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-01-2005
- Last Update Date
- 11-15-2011
- Code Navigator
A dermatologist like Suncoast Dermatology And Skin Surgery Center, Pa is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
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
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | |
| 2 | 207ND0900X | Allopathic & Osteopathic Physicians | Dermatology | |
| 3 | 207NS0135X | Allopathic & Osteopathic Physicians | Dermatology |
Group Taxonomy 193400000X MULTIPLE 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:
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
- BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
- BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
- BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS
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 |
|---|---|---|---|
| 377238100 | MEDICAID (05) | FL | |
| CA6816 | OTHER (01) | FL | SRRGA |
| 39435 | MEDICARE ID-TYPE UNSPECIFIED (04) | FL | LECANTO LOCATION |
| 39435A | MEDICARE ID-TYPE UNSPECIFIED (04) | FL | OCALA LOCATION |
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
- 10D0272561
- Facility Type
- Physician Office
- Certificate Effective Date
- September 30, 2024
- Certificate Expiration Date
- September 29, 2026
- Laboratory Director
- DR. RALPH E. MASSULLO JR
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Suncoast Dermatology And Skin Surgery Center, Pa 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 | 9 | 0 | 2 | 8 | 9 | 0 | 2 | 3 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 0 | 2 | 16 | 9 | 0 | 2 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 0 + 2 + 1 + 6 + 9 + 0 + 2 + 6 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1902890239 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1396794103 | ELIZABETH M ESTES ARNP Individual | Nurse Practitioner | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1114461274 | ASHTON MAE WESTER ARNP Individual | Nurse Practitioner | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1043204365 | DR. WILLIAM ARCH WELTON III MD Individual | Dermatology (MOHS-Micrographic Surgery) | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1073507455 | DR. MARGARET ANNE COLLINS MD Individual | Dermatology | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1104810563 | DR. RALPH EUGENE MASSULLO JR. MD Individual | Dermatology (MOHS-Micrographic Surgery) | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1114643152 | JASON SIREL APRN Individual | Nurse Practitioner (Gerontology) | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1124012596 | MR. BRIAN KEITH BONOMO PAC Individual | Physician Assistant | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1164075560 | NANCY HINDALONG APRN Individual | Nurse Practitioner | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1316511728 | CAITLIN NICHOLE ONORATO APRN Individual | Nurse Practitioner | 525 N DACIE PT LECANTO, FL 34461 (352) 746-2200 |
| 1457855603 | MS. AMY L LECUONA NP Individual | Nurse Practitioner (Family) | 525 N DACIE PT LECANTO, FL 34461 (813) 321-1786 |
| 1649758004 | KEELY M STATEN PA-C Individual | Physician Assistant | 525 N DACIE PT LECANTO, FL 34461 (813) 321-1786 |
| 1235902792 | AUSTIN JOHN BURKET PA-C Individual | Physician Assistant | 525 N DACIE PT LECANTO, FL 34461 (813) 321-1786 |
| 1336489749 | PATRICIA KATHLEEN SPITZER PA Individual | Physician Assistant | 525 N DACIE PT LECANTO, FL 34461 (813) 321-1786 |
| 1699516708 | TAYLOR ANNE HORNER PA-C Individual | Physician Assistant | 525 N DACIE PT LECANTO, FL 34461 (813) 321-1786 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902890239, enumerated in the NPI registry as an "organization" on September 01, 2005
The provider is located at 525 N Dacie Pt Lecanto, Fl 34461 and the phone number is (352) 746-2200
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Florida. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D0272561 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 01, 2005. 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].
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