Individual provider Active NPI

Dhaval Bhanusali, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1033436019
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
281484 Issued in NY
Practice address
483 10TH Ave RM 310
New York, NY 10018-9737
Phone
(917) 970-9100
NPI assigned
Apr 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 281484 NY Primary

Addresses

Primary practice location

483 10TH Ave RM 310
New York, NY 10018-9737

Mailing address

483 10TH Ave RM 310
New York, NY 10018-9737
Phone (917) 970-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224002376 NY Practitioner - Dermatology 2961707260 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DB Dermatology PLLCGroup PAC ID 1759623531, 4 clinicians

Practice addresses (Care Compare)

483 10TH Ave
RM 310
New York, NY 10018-9737
Phone (917) 970-9100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Hills Dermatology Group PLLC Dermatology CurrentSince Dec 7, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Dermatology CurrentSince Sep 16, 2017 Accepting new patients
Sherry Shieh, M.D., P.C. Dermatology CurrentSince Jan 7, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 16, 2017 Accepting new patients
Eric Huang M.D., P.C. Dermatology PastSince Nov 26, 2017 Accepting new patients
Sadick Aesthetic Surgery and Dermatology Dermatology PastSince Nov 30, 2015 Accepting new patients

Locations

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

928 Broadway
Ste 204
New York, NY 10010
Phone (212) 982-8229

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1033436019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 10TH AVE RM 310",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100189737",
            "telephone_number": "917-970-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 10TH AVE RM 310",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100189737",
            "telephone_number": "917-970-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANUSALI",
        "first_name": "DHAVAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-29",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "281484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.