Individual provider Active NPI

Richard Walter Urbanek, M.D.

  • Specialist
  • Staten Island, NY
National Provider Identifier
1043286065
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
127096 Issued in NY
Practice address
1324 Victory Blvd
Staten Island, NY 10301-3917
Phone
(718) 448-4488
Fax
(718) 442-4874
NPI assigned
Feb 28, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 127096 NY Primary

Addresses

Primary practice location

1324 Victory Blvd
Staten Island, NY 10301-3917

Mailing address

1324 Victory Blvd
Staten Island, NY 10301-3917
Phone (718) 448-4488

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
I20050811001118 NY Practitioner - Dermatology 3779529342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
JS Weill Medical College, Cornell University, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clark Dermatology LLCGroup PAC ID 5395703573, 46 clinicians

Practice addresses (Care Compare)

1324 Victory Blvd
Staten Island, NY 10301-3917
Phone (718) 448-4488

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions563
Removal or shaving of skin growth16
Skin biopsy107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Dermatology LLC CurrentSince May 8, 2015 Accepting new patients
Clark Dermatology, LLC PastSince May 11, 2025 Accepting new patients

Locations

1075 Central Ave
Clark, NJ 07066
Phone (732) 574-1399

469 Morris Ave
Ste 3
Elizabeth, NJ 07208
Phone (732) 574-1399

1324 Victory Blvd
Staten Island, NY 10301
Phone (718) 448-4488

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: richard.urbanek@metroderm.eclinicaldirectplus.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043286065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013917",
            "telephone_number": "718-448-4488",
            "fax_number": "718-442-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013917",
            "telephone_number": "718-448-4488",
            "fax_number": "718-442-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANEK",
        "first_name": "RICHARD",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "127096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.