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ROCHESTER DERMATOLOGIC SURGERY PC
NPI 1770149080
Dermatology - MOHS-Micrographic Surgery in Victor, NY

Active since May 13, 2019CLIA 33D2168114 · Certificate of Compliance
7400 PITTSFORD VICTOR RD, VICTOR, NY 14564(585) 222-1400(585) 222-1414 Get Directions Write a Review

NPPES record last updated: May 29, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 29, 2019, May 13, 2019 (2 updates tracked since 2019).

About Rochester Dermatologic Surgery Pc NPPES

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

ROCHESTER DERMATOLOGIC SURGERY PC (NPI 1770149080) is a healthcare organization registered as a mohs-micrographic surgery in Victor, New York and active in the NPI registry since May 2019. The organization holds a CLIA Certificate of Compliance certificate valid through March 9, 2028 and lists Sherrif F Ibrahim, Owner, as its authorized official.

NPPES Registry Identity

NPI1770149080
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameROCHESTER DERMATOLOGIC SURGERY PC
Location Address7400 PITTSFORD VICTOR RDVictor, NY 14564-9725
Mailing Address7400 Pittsford Victor RdVictor, NY 14564-9725
Phone(585) 222-1400
Fax(585) 222-1414
Organization SubpartNo
Authorized OfficialSherrif F IbrahimOwner · (206) 915-3484
Enumeration DateMay 13, 2019
Last NPPES UpdateMay 29, 20192 updates tracked since enumeration
✔ NPI 1770149080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
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
7400 PITTSFORD VICTOR RD, Victor, NY 14564
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Group Practice 2

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rochester Dermatologic Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Rochester Dermatologic Surgery PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Alexandra Bender, MD, PHD
Dermatology
NPI 1689063513
7400 PITTSFORD VICTOR RD
Victor, NY 14564
(585) 222-1400
✔ PECOS✔ Accepts MedicareSame address
Kelly Demchuk, NP
Nurse Practitioner
NPI 1790297513
7400 PITTSFORD VICTOR RD STE B
Victor, NY 14564
(585) 222-1400
✔ PECOS✔ Accepts Medicare2.4 mi
Sherrif Ibrahim, MD
Dermatology
NPI 1508975731
7400 PITTSFORD VICTOR RD
Victor, NY 14564
(585) 222-1400
✔ PECOS✔ Accepts Medicare2.4 mi
William Sipprell, M.D.
Micrographic Dermatologic Surgery (MDS)
NPI 1699182881
7400 PITTSFORD VICTOR RD STE B
Victor, NY 14564
(585) 222-1400
✔ PECOS✔ Accepts Medicare2.4 mi
Daniel Bax, MD
Dermatology
NPI 1598254005
6000 BROCKTON DRIVE
Lockport, NY 14094
(716) 845-3400
✔ PECOS✔ Accepts Medicare64 mi
Desiree Ratner, M.D.
Dermatology
NPI 1548360795
115 E 61ST ST FL 9
New York, NY 10065
(212) 814-5884
✔ PECOS236 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

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 33D2168114

Rochester Dermatologic Surgery, PC · Victor, NY
Active · expires Mar 9, 2028
CLIA Number33D2168114
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2026
Certificate Expiration DateMarch 9, 2028
Laboratory DirectorDr. Sherrif F. Ibrahim
Laboratory Phone(585) 222-1400
Laboratory LocationRochester Dermatologic Surgery, PC7400 Pittsford Victor Rd, Victor, NY 14564
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 Rochester Dermatologic Surgery PC's NPI number?

The NPI number for Rochester Dermatologic Surgery PC is 1770149080. It was assigned to this organization in the NPPES registry on May 13, 2019.

Where is Rochester Dermatologic Surgery PC located?

Rochester Dermatologic Surgery PC is located at 7400 Pittsford Victor Rd, Victor, NY 14564. The listed phone number is (585) 222-1400.

What is Rochester Dermatologic Surgery PC's specialty?

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

Is Rochester Dermatologic Surgery PC enrolled in Medicare?

Yes. Rochester Dermatologic Surgery PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Rochester Dermatologic Surgery PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Rochester Dermatologic Surgery PC. 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 (4), Micrographic Dermatologic Surgery (MDS) (1) and Nurse Practitioner (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Rochester Dermatologic Surgery PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 33D2168114) is associated with this NPI, valid through March 9, 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 Rochester Dermatologic Surgery PC was last updated on May 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.