Organization Active NPI

Felderman Dermatology LLC

  • Specialist
  • New York, NY
National Provider Identifier
1003140765
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1159201 Issued in NY
Legal business name
FELDERMAN DERMATOLOGY LLC
Practice address
74 E 79TH St Apt 1B
New York, NY 10075-0266
Phone
(212) 734-0091
Fax
(212) 861-8456
NPI assigned
Sep 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lenora Irma Felderman, M.D. , D.O.NPI 1235264011
Title
Dermatologist
Phone
(212) 734-0091

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 1159201 NY Primary

Addresses

Primary practice location

74 E 79TH St Apt 1B
New York, NY 10075-0266

Mailing address

74 E 79TH St Apt 1B
New York, NY 10075-0266
Phone (212) 734-0091

Other names 1

  • LENORA FELDERMAN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091215000379 NY Part B Supplier - Clinic/Group Practice 8628118080 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

1317 3rd Ave
Fl 8
New York, NY 10021
Phone (212) 434-6400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1003140765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 E 79TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750266",
            "telephone_number": "212-734-0091",
            "fax_number": "212-861-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 E 79TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750266",
            "telephone_number": "212-734-0091",
            "fax_number": "212-861-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELDERMAN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "FELDERMAN",
        "authorized_official_first_name": "LENORA",
        "authorized_official_middle_name": "IRMA",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "212-734-0091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D. , D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1159201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LENORA FELDERMAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.