SUGURU IMAEDA (MD) – Dermatology Physician, NPI 1760472237

SUGURU IMAEDA (MD) is a healthcare provider. based in New haven, Connecticut. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 032326 (CT). The NPI Number for SUGURU IMAEDA (MD) is 1760472237

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
SUGURU IMAEDA (MD)
NPI
1760472237
Phone
(203) 432-0076
Address
PO BOX 208237
Enumeration Date
26 October 2005
Last Update Date
29 December 2010

Doctor Profile

Medical School Name
ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Secondary Phone
2036886445
Graduation Year
1988 (38 years ago)
PAC ID
4587555396
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20040322001517
Address ID
CT065103221NE15XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

270 DERMATOLOGY in CT

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Provider Addresses for SUGURU IMAEDA (MD)

  • PO BOX 208237

    55 LOCK STREET

    NEW HAVEN, CT 065208237

    Phone: (203) 432-0076

    Fax: (203) 432-7289

    Type: Mailing

  • 55, Lock Street, Dixwell, New Haven, New Haven County, Connecticut, 06511, United States

    NEW HAVEN, CT 065208237

    Phone: (203) 432-0076

    Fax: (203) 432-7289

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040322001517IDermatologyCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9469$0
17003Destruction of precancer skin growth, 2-14 growths4914$0
17000Destruction of precancer skin growth, 1 growth2925$0
11102Biopsy of related skin growth, first growth1816$0
View full utilization report →

Insurance plans in this area (ZIP 06520)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436061736View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
H E M A T O L O G Y/ O N C O L O G YCT
Internal Medicine, NephrologySC
-CT
-NC
Internal MedicineCT
-CT
Cardiac SurgeryCT
-CT
-CT

Reviews

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Frequently asked questions

What is the 10-digit NPI for SUGURU IMAEDA (MD)?
SUGURU IMAEDA (MD) — NPI 1760472237 — is the standard way to identify this listing.
Does CMS list SUGURU IMAEDA (MD) as active?
Yes — SUGURU IMAEDA (MD) is active in the NPI listing used on this page.
What healthcare role does SUGURU IMAEDA (MD) hold?
Scheduling teams often label SUGURU IMAEDA (MD) under Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where is SUGURU IMAEDA (MD) based?
SUGURU IMAEDA (MD) is tied to New Haven, Connecticut in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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