EMPIRE DERMATOLOGY PLLC
NPI 1336698406
Dermatology - MOHS-Micrographic Surgery in East Syracuse, NY
NPI Status: Active since September 29, 2016
Contact Information
5823 WIDEWATERS PKWY
SUITE 4
EAST SYRACUSE, NY
ZIP 13057
Phone: (315) 500-7546
Fax: (888) 454-8316
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- CLIA Number: 33D2271101
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-26-2026
About EMPIRE DERMATOLOGY PLLC
This page provides the complete NPI Profile along with additional information for Empire Dermatology Pllc, a provider established in East Syracuse, New York operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1336698406 assigned on September 2016. The practitioner's primary taxonomy code is 207ND0101X with license number 282257 (NY). The provider is registered as an organization and their NPI record was last updated 3 years ago. Empire Dermatology Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Ms. Patricia H Madden (Practice Manager)
- NPI
- 1336698406
- Provider Name
- EMPIRE DERMATOLOGY PLLC
- Entity Type
- Organization
- Location Address
- 5823 WIDEWATERS PKWY SUITE 4 EAST SYRACUSE, NY 13057
- Location Phone
- (315) 500-7546
- Location Fax
- (888) 454-8316
- Mailing Address
- 5823 WIDEWATERS PKWY SUITE 4 EAST SYRACUSE, NY 13057
- Mailing Phone
- (315) 500-7546
- Mailing Fax
- (888) 454-8316
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-29-2016
- Last Update Date
- 03-16-2023
- 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.
- 282257
- License State
- NY
- 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.
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 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | |
| 2 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology |
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.
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
- 33D2271101
- Facility Type
- Physician Office
- Certificate Effective Date
- October 27, 2024
- Certificate Expiration Date
- October 26, 2026
- Laboratory Director
- BRIAN A. RAPHAEL
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Empire Dermatology Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1336698406, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
EAST SYRACUSE, NY 13057
EAST SYRACUSE, NY 13057
EAST SYRACUSE, NY 13057
EAST SYRACUSE, NY 13057
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336698406, enumerated as an "organization" on September 29, 2016.
The provider is located at 5823 WIDEWATERS PKWY SUITE 4 EAST SYRACUSE, NY 13057 and the phone number is (315) 500-7546.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
