Organization Active NPI

Heights Dermatology and Laser Group PC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1013058890
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
192349 Issued in NY
Legal business name
HEIGHTS DERMATOLOGY AND LASER GROUP PC
Practice address
115 Remsen St
Brooklyn, NY 11201-4212
Phone
(718) 852-4646
Fax
(718) 624-5972
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Dr. Marc Robert Avram, MDNPI 1629063748
Title
Physician
Phone
(718) 852-4646

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 192349 NY Primary

Addresses

Primary practice location

115 Remsen St
Brooklyn, NY 11201-4212

Mailing address

115 Remsen St
Brooklyn, NY 11201-4212
Phone (718) 852-4646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080613000319 NY Part B Supplier - Clinic/Group Practice 7719058023 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1013058890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 REMSEN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014212",
            "telephone_number": "718-852-4646",
            "fax_number": "718-624-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 REMSEN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014212",
            "telephone_number": "718-852-4646",
            "fax_number": "718-624-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIGHTS DERMATOLOGY AND LASER GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "AVRAM",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-852-4646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "192349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.