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FAIRFIELD DERMATOLOGY, P.C.
NPI 1023295524
Specialist in Fairfield, CT

Active since January 28, 2008CLIA 07D0096503 · Certificate of Compliance
1305 POST RD, 310, FAIRFIELD, CT 06824(203) 259-7709(203) 255-3585 Get Directions Write a Review

NPPES record last updated: October 3, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Fairfield Dermatology, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRFIELD DERMATOLOGY, P.C. (NPI 1023295524) is a healthcare organization registered as a specialist in Fairfield, Connecticut and active in the NPI registry since January 2008. The organization holds a CLIA Certificate of Compliance certificate valid through January 18, 2028 and lists Ivan S. Cohen, President, as its authorized official.

NPPES Registry Identity

NPI1023295524
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameFAIRFIELD DERMATOLOGY, P.C.
Location Address1305 POST RD, 310Fairfield, CT 06824-6016
Mailing Address1305 Post Rd, 310Fairfield, CT 06824-6016 · (203) 259-7709 · Fax (203) 255-3585
Phone(203) 259-7709
Fax(203) 255-3585
Organization SubpartNo
Authorized OfficialIvan S. CohenPresident · (203) 259-7709
Enumeration DateJanuary 28, 2008
Last NPPES UpdateOctober 3, 2018
✔ NPI 1023295524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CT · 14371
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1305 POST RD, Fairfield, CT 06824
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Other Identifiers 1

OtherC02974CT · Medicare Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fairfield Dermatology, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Fairfield Dermatology, P.C., which bills Medicare for the services they deliver. Of these, 8 practice at this address. They are listed nearest first.

Clinicians, nearest first (8)

Blake Brooks, MD
Dermatology
NPI 1407340888
1305 POST RD STE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Ivan Cohen, MD
Dermatology
NPI 1851488191
1305 POST ROAD SUITE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Michelle Goncalves, APRN
Nurse Practitioner
NPI 1346625381
1305 POST RD SUITE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Yesul Kim, MD
Dermatology
NPI 1144725672
1305 POST RD STE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Jason Mcbean, M.D.
Dermatology
NPI 1649492752
1305 POST RD SUITE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Gerarda Pires, APRN
Nurse Practitioner
NPI 1528545845
1305 POST RD STE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Smith, M.D.
Dermatology
NPI 1528226750
1305 POST RD SUITE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOS✔ Accepts MedicareSame address
Kelly Caione, APRN
Nurse Practitioner
NPI 1558119917
1305 POST RD STE 310
Fairfield, CT 06824
(203) 259-7709
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 07D0096503

Fairfield Dermatology · Fairfield, CT
Active · expires Jan 18, 2028
CLIA Number07D0096503
Laboratory TypePhysician Office
Certificate Effective DateJanuary 19, 2026
Certificate Expiration DateJanuary 18, 2028
Laboratory DirectorYesul Kim
Laboratory Phone(203) 259-7709
Laboratory LocationFairfield Dermatology1305 Post Rd Ste 310, Fairfield, CT 06824
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairfield Dermatology, P.C.'s NPI number?

The NPI number for Fairfield Dermatology, P.C. is 1023295524. It was assigned to this organization in the NPPES registry on January 28, 2008.

Where is Fairfield Dermatology, P.C. located?

Fairfield Dermatology, P.C. is located at 1305 Post Rd 310, Fairfield, CT 06824. The listed phone number is (203) 259-7709.

What is Fairfield Dermatology, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Fairfield Dermatology, P.C. enrolled in Medicare?

Yes. Fairfield Dermatology, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fairfield Dermatology, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Fairfield Dermatology, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (5) and Nurse Practitioner (3). Of these, 8 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Fairfield Dermatology, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 07D0096503) is associated with this NPI, valid through January 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fairfield Dermatology, P.C. was last updated on October 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.