Individual provider Active NPI

Valerie A Gershenhorn, D.O.

  • Dermatology Physician
  • Middletown, NY
National Provider Identifier
1063618767
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
227789 Issued in NY
Practice address
95 Crystal Run Rd
Middletown, NY 10941-7001
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Jun 21, 2007
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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 227789 NY Primary

Addresses

Primary practice location

95 Crystal Run Rd
Middletown, NY 10941-7001

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
03068600MedicaidNY

Other names 1

  • Valerie A Nozad Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address valerie.gershenhorndo.p1@direct.crystalrun.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070906000395 NJ Practitioner - Dermatology 9335232479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2000
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)

469 Morris Ave
Suite 2
Elizabeth, NJ 07208-2904
Phone (908) 512-7900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions128
Removal or shaving of skin growth1-10
Skin biopsy67

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Dermatology LLC Dermatology CurrentSince Jul 14, 2021 Accepting new patients
Clark Dermatology, LLC Dermatology PastSince May 11, 2025 Accepting new patients

Locations

36 Newark Ave
Ste 214
Belleville, NJ 07109
Phone (973) 751-1200

1425 Pompton Ave
Ste 1-1
Cedar Grove, NJ 07009
Phone (973) 785-8686

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

3 State Route 27
Ste 305
Edison, NJ 08820
Phone (732) 549-2448

469 Morris Ave
Ste 2
Elizabeth, NJ 07208
Phone (908) 351-6060

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

703 Kearny Ave
Kearny, NJ 07032
Phone (201) 332-4500

622 Boulevard
Kenilworth, NJ 07033
Phone (908) 241-3181

400 Franklin Tpke
Ste 208
Mahwah, NJ 07430
Phone (201) 825-0009

175 Cedar Ln
Ste A
Teaneck, NJ 07666
Phone (201) 692-8354

5809 Madison St
West New York, NJ 07093
Phone (201) 770-1370

Organizations & group practices 2

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1063618767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417001",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHENHORN",
        "first_name": "VALERIE",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "227789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03068600",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "valerie.gershenhorndo.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "95 Crystal Run Rd",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109417001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "NOZAD",
            "middle_name": "A",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.