Eastbay Medical PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

EASTBAY MEDICAL PC

Practice address

2307 Bellmore Ave
Bellmore, NY 11710-5651

Phone

(516) 308-7070

Fax

(516) 308-7071

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jordan Fabrikant, DONPI 1649585753

Title

DO

Phone

(516) 308-7070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert L Kraft, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • Forest Hills, NY
  • NPI 1245238583
  Medicare reassignment Care Compare group NPD
• Jeffrey Alan Sklar, MD

  • Dermatology Physician
  • Woodbury, NY
  • NPI 1104898204
  Medicare reassignment Care Compare group NPD
• Jordan Fabrikant, D.O.

  • MOHS-Micrographic Surgery Physician
  • Orange City, FL
  • NPI 1649585753

  Dermatology, NY

  Medicare reassignment NPD Authorized official
• Lori Ann Friedman, PA

  • Physician Assistant
  • New York, NY
  • NPI 1962633347
  Medicare reassignment Care Compare group
• Kenneth Robert Francis, MD

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1326076464
  Medicare reassignment NPD
• Ashish Kumar, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Plainview, NY
  • NPI 1518302967
  Medicare reassignment NPD
• Rachel Hayes

  • Physician Assistant
  • Bellmore, NY
  • NPI 1336986421
  Medicare reassignment
• Rebecca Massone, PA-C

  • Physician Assistant
  • Bellmore, NY
  • NPI 1003410168
  Medicare reassignment

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1063272474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 BELLMORE AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105651",
            "telephone_number": "513-308-7070",
            "fax_number": "516-308-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 BELLMORE AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105651",
            "telephone_number": "516-308-7070",
            "fax_number": "516-308-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTBAY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "FABRIKANT",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "516-308-7070",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beatriz Elena Duque
• Nikolina Dusi
• Fiona Eapen, RPA-C
• Early Prime Services Inc.
• East Bay Chiropractic Wellnes PC
• Ec Medical PLLC
• Ei Kid Unlimited N.B.S. Corp
• Jeffrey Eiskowitz
• Maria Eleftheriou
• Nicole Ellis

• Dermatology Physician in Bellmore, NY
• Providers in Bellmore, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.