MARIWALLA DERMATOLOGY, PLLC
NPI 1891094322
Dermatology - MOHS-Micrographic Surgery in West Islip, NY

Q: What is Mariwalla Dermatology, PLLC's NPI number?

The NPI number for Mariwalla Dermatology, PLLC is 1891094322. It was assigned to this organization in the NPPES registry on March 23, 2011.

Q: What is Mariwalla Dermatology, PLLC's specialty?

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

Active since March 23, 2011

1253 MONTAUK HWY, WEST ISLIP, NY 11795(631) 665-3376(631) 969-3376 Get Directions Write a Review

NPPES record last updated: April 20, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Mariwalla Dermatology, Pllc NPPES

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

MARIWALLA DERMATOLOGY, PLLC (NPI 1891094322) is a healthcare organization registered as a mohs-micrographic surgery in West Islip, New York and active in the NPI registry since March 2011. The organization lists Kavita Mariwalla, Owner, as its authorized official.

NPPES Registry Identity

NPI1891094322

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameMARIWALLA DERMATOLOGY, PLLC

Location Address1253 MONTAUK HWYWest Islip, NY 11795-4916

Mailing Address1253 Montauk HwyWest Islip, NY 11795-4916 · (631) 665-3376 · Fax (631) 969-3376

Phone(631) 665-3376

Fax(631) 969-3376

Organization SubpartNo

Authorized OfficialKavita MariwallaOwner · (631) 665-3376

Enumeration DateMarch 23, 2011

Last NPPES UpdateApril 20, 2017

✔ NPI 1891094322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

1253 MONTAUK HWY, West Islip, NY 11795

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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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Mariwalla Dermatology, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Kavita Mariwalla, M.D

Micrographic Dermatologic Surgery (MDS)

NPI 1962674184

1253 MONTAUK HIGHWAY
West Islip, NY 11795

(631) 665-3376

✔ PECOS✔ Accepts Medicare0.2 mi

Jeanne Marie Franck, M.D.

Dermatology

NPI 1982671814

16 E 98TH ST OFC 1F
New York, NY 10029

(212) 348-3414

✔ PECOS✔ Accepts Medicare35 mi

Lauren Mohan

Dermatology

NPI 1457974123

2356 MOHAWK LN
Glenview, IL 60026

(847) 610-0926

✔ PECOS✔ Accepts Medicare762 mi

Imara-Safi Scott, MD

Dermatology

NPI 1053801001

1632 RIGGINS RD
Tallahassee, FL 32308

(850) 877-4134

✔ PECOS✔ Accepts Medicare936 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mariwalla Dermatology, PLLC's NPI number?

The NPI number for Mariwalla Dermatology, PLLC is 1891094322. It was assigned to this organization in the NPPES registry on March 23, 2011.

Where is Mariwalla Dermatology, PLLC located?

Mariwalla Dermatology, PLLC is located at 1253 Montauk Hwy, West Islip, NY 11795. The listed phone number is (631) 665-3376.

What is Mariwalla Dermatology, PLLC's specialty?

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

Is Mariwalla Dermatology, PLLC enrolled in Medicare?

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

How many clinicians bill Medicare through Mariwalla Dermatology, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Mariwalla 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) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mariwalla Dermatology, PLLC was last updated on April 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.