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SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
NPI 1770770547
Dermatology - MOHS-Micrographic Surgery in Providence, RI

Active since September 26, 2007CLIA Certified · 2 labs
1 RANDALL SQ, SUITE 306, PROVIDENCE, RI 02904(401) 751-7546(401) 751-6888 Get Directions Write a Review

NPPES record last updated: March 4, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Surgical & Cosmetic Dermatology Of Rhode Island, Llc NPPES

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

SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC (NPI 1770770547) is a healthcare organization registered as a mohs-micrographic surgery in Providence, Rhode Island and active in the NPI registry since September 2007. The organization holds 2 active CLIA laboratory certificates and lists Marina Kuperman-beade, Owner, as its authorized official.

NPPES Registry Identity

NPI1770770547
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameSURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
Location Address1 RANDALL SQ, SUITE 306Providence, RI 02904-2709
Mailing Address1 Randall Sq, Suite 306Providence, RI 02904-2709 · (401) 751-7546 · Fax (401) 751-6888
Phone(401) 751-7546
Fax(401) 751-6888
Organization SubpartNo
Authorized OfficialMarina Kuperman-beadeOwner · (401) 751-7546
Enumeration DateSeptember 26, 2007
Last NPPES UpdateMarch 4, 2016
✔ NPI 1770770547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in RI · MD10753
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.
1 RANDALL SQ, Providence, RI 02904
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Other Identifiers 4

OtherDD6437RI · Railroad Medicare
Medicaid9003758RI
Medicare PIN709003758RI
Medicare UPINH15417RI

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 41D1029941

Surgical And Cosmetic Dermatology Of Rhode Island, LLC · Providence, RI
Active · expires Jun 5, 2027
CLIA Number41D1029941
Laboratory TypePhysician Office
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorMarina Kuperman-Beade
Laboratory Phone(401) 751-7546
Laboratory LocationSurgical And Cosmetic Dermatology Of Rhode Island, LLC1 Randall Square Ste 306, Providence, RI 02904
CLIA data matches this NPI record on: Address 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 of Compliance 22D2103343

Surgical And Cosmetic Dermatology Of Rhode Island LLC · Fall River, MA
Active · expires Feb 15, 2028
CLIA Number22D2103343
Laboratory TypePhysician Office
Certificate Effective DateFebruary 16, 2026
Certificate Expiration DateFebruary 15, 2028
Laboratory DirectorMarina Kuperman-Beade
Laboratory Phone(401) 751-7546
Laboratory LocationSurgical And Cosmetic Dermatology Of Rhode Island LLC1030 President Ave Suite 307, Fall River, MA 02720
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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.

PHINA A MAYU NP
Nurse Practitioner (Adult Health)
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339
MAYELIN PACHECO NUNEZ NP
Nurse Practitioner (Family)
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339
STANLEY H. BLOCK MD
Allergy & Immunology
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 444-0414
DR. JAMES J YASHAR M.D
Specialist
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (140) 196-5777
THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339
PAUL W WEHBE MD
Pediatrics
1 RANDALL SQ, SUITE 404-406
PROVIDENCE, RI 02904
Providence County (401) 861-5183
CARDIOLOGY CONSULTANTS, LLC
Internal Medicine (Cardiovascular Disease)
1 RANDALL SQ, SUITE 305
PROVIDENCE, RI 02904
Providence County (401) 223-0223
BRIANA J. WALSH NP
Nurse Practitioner (Family)
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339

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 Surgical & Cosmetic Dermatology Of Rhode Island, LLC's NPI number?

The NPI number for Surgical & Cosmetic Dermatology Of Rhode Island, LLC is 1770770547. It was assigned to this organization in the NPPES registry on September 26, 2007.

Where is Surgical & Cosmetic Dermatology Of Rhode Island, LLC located?

Surgical & Cosmetic Dermatology Of Rhode Island, LLC is located at 1 Randall Sq Suite 306, Providence, RI 02904. The listed phone number is (401) 751-7546.

What is Surgical & Cosmetic Dermatology Of Rhode Island, LLC's specialty?

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

Does Surgical & Cosmetic Dermatology Of Rhode Island, LLC hold CLIA laboratory certificates?

Yes. 2 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.

What insurance does Surgical & Cosmetic Dermatology Of Rhode Island, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Surgical & Cosmetic Dermatology Of Rhode Island, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Surgical & Cosmetic Dermatology Of Rhode Island, LLC was last updated on March 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.