Active NPI
South Nassau Dermatology P.C.
- Specialist
- Oceanside, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 126210
- Legal business name
- SOUTH NASSAU DERMATOLOGY P.C.
- Practice address
- 258 Merrick Rd
Oceanside, NY 11572 - Phone
- (516) 766-0345
- Fax
- (516) 766-4690
- NPI assigned
- May 17, 2006
- Last updated
- Aug 27, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carl M Leichter, M.D.
- Title
- President
- Phone
- (516) 766-0345
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 126210 | NY | Primary |
Addresses
Primary practice location
258 Merrick Rd
Oceanside, NY 11572
Mailing address
258 Merrick Rd
Oceanside, NY 11572-1427
Phone (516) 766-0345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0686401 | South Nassau Dermatology | Compliance | Feb 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
335 W Park Ave
Long Beach, NY 11561
Phone (516) 431-1640
258 Merrick Rd
Oceanside, NY 11572
Phone (516) 766-0345
Practitioners & affiliated clinicians
Practitioners 17
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.
-
- Dermatology Physician
- Oceanside, NY
- NPI 1841415197
-
- MOHS-Micrographic Surgery Physician
- Oceanside, NY
- NPI 1275531857
-
- Dermatology Physician
- Oceanside, NY
- NPI 1538167242
-
- Dermatology Physician
- Oceanside, NY
- NPI 1346701836
-
- Dermatology Physician
- Oceanside, NY
- NPI 1336146232
-
- Dermatology Physician
- Oceanside, NY
- NPI 1417273988
-
- Specialist
- Oceanside, NY
- NPI 1780674184
-
- Dermatology Physician
- Oceanside, NY
- NPI 1932379690
-
- Dermatology Physician
- Oceanside, NY
- NPI 1003813916
-
- Medical Physician Assistant
- Inwood, NY
- NPI 1316928856
-
- Dermatology Physician
- Levittown, NY
- NPI 1548617715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1535328000000",
"number": "1144272899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 MERRICK RD",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115721427",
"telephone_number": "516-766-0345",
"fax_number": "516-766-4690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 MERRICK RD",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "11572",
"telephone_number": "516-766-0345",
"fax_number": "516-766-4690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH NASSAU DERMATOLOGY P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-17",
"last_updated": "2018-08-27",
"status": "A",
"authorized_official_last_name": "LEICHTER",
"authorized_official_first_name": "CARL",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "516-766-0345",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "126210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oceanside, NY
- South Nassau Communities Hospital
- South Nassau Communities Hospital
- South Nassau Communities Hospital
- South Nassau Communities Hospital
- South Nassau Communities Hospital-Surgical Oncology
- South Nassau Family Medicine PC
- South Nassau Neonatal Services, PC
- South Nassau Oncology, PC
- South Nassau Physician Group PC
- South Nassau Radiology PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.