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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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: October 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 14, 2026, Mar 16, 2023, Dec 13, 2022 and 1 more (4 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, maintains 5 additional practice locations, 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 UpdateOctober 14, 20264 updates tracked since enumeration
NPPES CertifiedOctober 14, 2026
✔ 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
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Secondary Practice Locations 5

Location 18138 Oswego Rd Ste 1Liverpool, NY 13090-1500 · Phone (315) 500-7546 · Fax (315) 378-4210
Location 2145 Sullys Trl Ste 1Pittsford, NY 14534-4561 · Phone (315) 500-7546 · Fax (315) 378-4210
Location 3301 Genesee St Ste FOneida, NY 13421-2644 · Phone (315) 500-7546 · Fax (315) 378-4210
Location 4605 Division St Ste 1North Tonawanda, NY 14120-4486 · Phone (315) 500-7546 · Fax (315) 378-4210
Location 55301 W Genesee St Ste 225Camillus, NY 13031-2261 · Phone (315) 500-7546 · Fax (315) 378-4210

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Empire Dermatology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Empire Dermatology PLLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Jeffrey Cizenski, MD
Dermatology
NPI 1821437104
5823 WIDEWATERS PKWY STE 4
East Syracuse, NY 13057
(315) 500-7546
✔ PECOS✔ Accepts MedicareSame address
Brittaney Hegard, NP
Nurse Practitioner
NPI 1548742315
5823 WIDEWATERS PKWY
East Syracuse, NY 13057
(315) 500-7546
✔ PECOSSame address
Brian Raphael, M.D.
Dermatology
NPI 1205121324
5823 WIDEWATERS PKWY SUITE 4
East Syracuse, NY 13057
(315) 500-7546
✔ PECOS✔ Accepts MedicareSame address
Hannah Singer, MD
Dermatology
NPI 1801391511
5823 WIDEWATERS PKWY
East Syracuse, NY 13057
(315) 500-7546
✔ PECOS✔ Accepts MedicareSame address
Sphoorthi Jinna, M. D.
Micrographic Dermatologic Surgery (MDS)
NPI 1588906028
5823 WIDEWATERS PKWY
East Syracuse, NY 13057
(315) 500-7546
✔ PECOS✔ Accepts MedicareSame address
Anne St Pierre, F.N.P.
Nurse Practitioner
NPI 1932148194
301 GENESEE ST STE F
Oneida, NY 13421
(315) 500-7546
✔ PECOS✔ Accepts Medicare21 mi
Jenna Pawloski, FNP-C
Nurse Practitioner
NPI 1659866754
6 RHOADS DR
Utica, NY 13502
(315) 733-2777
✔ PECOS✔ Accepts Medicare39 mi

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 6

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 Waiver 33D2283263

Empire Dermatology PLLC · North Tonawanda, NY
Active · expires Jul 12, 2028
CLIA Number33D2283263
Laboratory TypePhysician Office
Certificate Effective DateJuly 13, 2026
Certificate Expiration DateJuly 12, 2028
Laboratory DirectorDr. Brian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology PLLC605 Division Street, Suite 1, North Tonawanda, NY 14120
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only 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: Address 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) 33D2349042

Empire Dermatology PLLC · Pittsford, NY
Active · expires Aug 13, 2028
CLIA Number33D2349042
Laboratory TypePhysician Office
Certificate Effective DateAugust 14, 2026
Certificate Expiration DateAugust 13, 2028
Laboratory DirectorBrian A. Raphael
Laboratory Phone(315) 500-7546
Laboratory LocationEmpire Dermatology PLLC145 Sully's Trail Suite 01-03, Pittsford, NY 14534
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 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
Expired · 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: Address 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.

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.

Is Empire Dermatology PLLC enrolled in Medicare?

Yes. Empire Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Empire Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Empire Dermatology PLLC. 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 (3), Nurse Practitioner (3) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.