SEAPORT DERMATOLOGY – NPI #1376575324
Dermatology

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.

SEAPORT DERMATOLOGY is a dermatologist located in MYSTIC, CT. NPPES has assigned the NPI number 1376575324 to SEAPORT DERMATOLOGY on July 07, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SEAPORT DERMATOLOGY” is a dba name, the actual legal business name for this organization is JOHN R. WEST MD INC. The primary taxonomy selected by this provider is 207ND0101X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in MOHS-Micrographic Surgery

The NPI profile was previously updated about 13 years ago on Feb 06, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SEAPORT DERMATOLOGY below.

NPI Profile for
JOHN R. WEST MD INC

NPI Number
1376575324
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JOHN R. WEST MD INC
Doing Business As (dba): SEAPORT DERMATOLOGY
Primary location
34 WATER ST
SUITE 2
MYSTIC, CT 06355-2524
Phone: (860) 572-9994 Fax: (860) 572-9930
Mailing address
34 WATER ST # 2
MYSTIC, CT 06355-2524
Phone: (860) 572-9994 Fax: (860) 572-9930
Organization Subpart
No
Authorized Official
JOHN WEST
PRESIDENT
Phone: (860) 572-9994
Updated
Identifiers

Identifiers for SEAPORT DERMATOLOGY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE CROSS BLUE SHIELDCT010044204CT01
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207ND0101X
- Dermatology / MOHS-Micrographic Surgery (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.