SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
NPI 1770770547
Dermatology - MOHS-Micrographic Surgery in Providence, RI
NPI Status: Active since September 26, 2007
Contact Information
1 RANDALL SQ
SUITE 306
PROVIDENCE, RI
ZIP 02904
Phone: (401) 751-7546
Fax: (401) 751-6888
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- Accepts Insurance
- CLIA Number: 22D2103343
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-15-2028
About SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
This page provides the complete NPI Profile along with additional information for Surgical & Cosmetic Dermatology Of Rhode Island, Llc, a provider established in Providence, Rhode Island operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1770770547 assigned on September 2007. The practitioner's primary taxonomy code is 207ND0101X with license number MD10753 (RI). The provider is registered as an organization and their NPI record was last updated 10 years ago. 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 Dr. Marina Kuperman-beade M.d. (Owner)
- NPI
- 1770770547
- Provider Name
- SURGICAL & COSMETIC DERMATOLOGY OF RHODE ISLAND, LLC
- Entity Type
- Organization
- Location Address
- 1 RANDALL SQ SUITE 306 PROVIDENCE, RI 02904
- Location Phone
- (401) 751-7546
- Location Fax
- (401) 751-6888
- Mailing Address
- 1 RANDALL SQ SUITE 306 PROVIDENCE, RI 02904
- Mailing Phone
- (401) 751-7546
- Mailing Fax
- (401) 751-6888
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-26-2007
- Last Update Date
- 03-04-2016
- 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.
- MD10753
- License State
- RI
- 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.
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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| DD6437 | OTHER (01) | RI | RAILROAD MEDICARE |
| 9003758 | MEDICAID (05) | RI | |
| 709003758 | MEDICARE PIN (08) | RI | |
| H15417 | MEDICARE UPIN (02) | RI |
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
- 22D2103343
- Facility Type
- Physician Office
- Certificate Effective Date
- February 16, 2026
- Certificate Expiration Date
- February 15, 2028
- Laboratory Director
- MARINA KUPERMAN-BEADE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Surgical & Cosmetic Dermatology Of Rhode Island, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high 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 1770770547, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
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 63 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.
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770770547, enumerated as an "organization" on September 26, 2007.
The provider is located at 1 RANDALL SQ SUITE 306 PROVIDENCE, RI 02904 and the phone number is (401) 751-7546.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Railroad. Please consult your insurance carrier or call the provider to verify.
