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EMPIRE DERMATOLOGY PLLC
NPI 1336698406
Dermatology - MOHS-Micrographic Surgery in East Syracuse, NY

Active since September 29, 2016CLIA Certified · 5 labs
5823 WIDEWATERS PKWY, SUITE 4, EAST SYRACUSE, NY 13057(315) 500-7546(888) 454-8316 Get Directions Write a Review

NPPES record last updated: March 16, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 16, 2023, Dec 13, 2022, Sep 29, 2016 (3 updates tracked since 2016).

About Empire Dermatology Pllc NPPES

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

EMPIRE DERMATOLOGY PLLC (NPI 1336698406) is a healthcare organization registered as a mohs-micrographic surgery in East Syracuse, New York and active in the NPI registry since September 2016. The organization holds 5 active CLIA laboratory certificates and lists Patricia H Madden, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1336698406
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameEMPIRE DERMATOLOGY PLLC
Location Address5823 WIDEWATERS PKWY, SUITE 4East Syracuse, NY 13057-3084
Mailing Address5823 Widewaters Pkwy, Suite 4East Syracuse, NY 13057-3084 · (315) 500-7546 · Fax (315) 378-4210
Phone(315) 500-7546
Fax(888) 454-8316
Organization SubpartNo
Authorized OfficialPatricia H MaddenPractice Manager · (315) 935-9247
Enumeration DateSeptember 29, 2016
Last NPPES UpdateMarch 16, 20233 updates tracked since enumeration
NPPES CertifiedMarch 16, 2023
✔ NPI 1336698406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in NY · 282257
Definition
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.
Also ListedDermatologyTaxonomy 207N00000X
5823 WIDEWATERS PKWY, East Syracuse, NY 13057
Open in Google Maps ↗

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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

CLIA Laboratory Certificates CMS CLIA 5

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 for Provider-Performed Microscopy Procedures (PPMP) 33D2283263

Empire Dermatology · North Tonawanda, NY
Active · expires Jun 4, 2027
CLIA Number33D2283263
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorDr. Brian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology605 Division Street, Suite 1, North Tonawanda, NY 14120
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D2210921

Empire Dermatology PLLC · Fulton, NY
Active · expires Apr 30, 2027
CLIA Number33D2210921
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorDr. Brian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology PLLC522 South 4th Street Suite 1300, Fulton, NY 13069
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D2252662

Empire Dermatology PLLC · Camillus, NY
Active · expires Apr 30, 2027
CLIA Number33D2252662
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorDr. Brian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology PLLC5301 West Genesee Street Suite 225, Camillus, NY 13031
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 33D2117332

Empire Dermatology PLLC · E Syracuse, NY
Active · expires Mar 6, 2027
CLIA Number33D2117332
Laboratory TypePhysician Office
Certificate Effective DateMarch 7, 2025
Certificate Expiration DateMarch 6, 2027
Laboratory DirectorDr. Brian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology PLLC5823 Widewaters Parkway, Suite 10, E Syracuse, NY 13057
CLIA data matches this NPI record on: 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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D2271101

Empire Dermatology · Oneida, NY
Active · expires Oct 26, 2026
CLIA Number33D2271101
Laboratory TypePhysician Office
Certificate Effective DateOctober 27, 2024
Certificate Expiration DateOctober 26, 2026
Laboratory DirectorBrian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology301 Genesee Street Suite F, Oneida, NY 13421
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK RUSSO ATC, CSCS
Specialist/Technologist (Athletic Trainer)
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 701-4000
HEIDI LEIGH DIMEIS NP
Nurse Practitioner
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 500-7546
RENEE S MELFI MD
Physical Medicine & Rehabilitation (Pain Medicine)
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 701-4000
CONNOR DELANEY DPT
Physical Therapist
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 418-4013
BRIAN RAPHAEL M.D.
Dermatology (MOHS-Micrographic Surgery)
5823 WIDEWATERS PKWY, SUITE 4
EAST SYRACUSE, NY 13057
Onondaga County (315) 500-7546
RSM MEDICAL ASSOCIATES, PLLC
Orthopaedic Surgery
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 426-0190
MARGARET DRESCHER PA
Physician Assistant
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 500-7546
CNY INTERNISTS, PC
Internal Medicine
5823 WIDEWATERS PKWY
EAST SYRACUSE, NY 13057
Onondaga County (315) 449-4028

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 Empire Dermatology PLLC's NPI number?

The NPI number for Empire Dermatology PLLC is 1336698406. It was assigned to this organization in the NPPES registry on September 29, 2016.

Where is Empire Dermatology PLLC located?

Empire Dermatology PLLC is located at 5823 Widewaters Pkwy Suite 4, East Syracuse, NY 13057. The listed phone number is (315) 500-7546.

What is Empire Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Empire Dermatology PLLC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Empire Dermatology PLLC was last updated on March 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.