Organization Active NPI

Michael Paltiel MD PC

  • Medical Specialty Clinic/Center
  • Great Neck, NY
National Provider Identifier
1013175165
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
245541 Issued in NY
Legal business name
MICHAEL PALTIEL MD PC
Practice address
107 Northern Blvd Ste 206
Great Neck, NY 11021-4309
Phone
(516) 829-3376
Fax
(516) 829-2019
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Michael Paltiel, M.D.NPI 1760525935
Title
Dermatologist
Phone
(917) 526-8498

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
Medical Specialty Clinic/Center 261QM2500X 245541 NY Primary

Addresses

Primary practice location

107 Northern Blvd Ste 206
Great Neck, NY 11021-4309

Mailing address

10845 65TH Ave
Forest Hills, NY 11375-1419
Phone (917) 526-8498

Other names 1

  • Adult and Pediatric Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080717000520 NY Part B Supplier - Clinic/Group Practice 2163595729 Receives reassigned benefits from 3 practitioners
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1013175165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 65TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751419",
            "telephone_number": "917-526-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NORTHERN BLVD STE 206",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214309",
            "telephone_number": "516-829-3376",
            "fax_number": "516-829-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL PALTIEL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "PALTIEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "917-526-8498",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "245541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult and Pediatric Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.