Organization Active NPI

Skin & Aesthetic Surgery of Manhattan

  • Procedural Dermatology Physician
  • New York, NY
National Provider Identifier
1144835364
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
Legal business name
SKIN & AESTHETIC SURGERY OF MANHATTAN
Practice address
120 E 56TH St # 1500
New York, NY 10022-3607
Phone
(713) 922-7081
NPI assigned
Sep 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Authorized official

Name
Dr. Michelle Fern Henry, MDNPI 1154569275
Title
Dermatologist
Phone
(713) 922-7081

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)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X Primary

Addresses

Primary practice location

120 E 56TH St # 1500
New York, NY 10022-3607

Mailing address

1 Irving PL Apt G21B
New York, NY 10003-9708
Phone (713) 922-7081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926000282 NY Part B Supplier - Clinic/Group Practice 9133573165 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2223202Skin & Aesthetic Surgery of Manhattan PLLC120 East 56TH Street Suite 1500, New York, NY 10022Certificate of waiverMay 4, 2027

National Provider Directory

National Provider Directory

Locations

120 E 56th St
Ste 1500
New York, NY 10022
Phone (212) 870-8778

120 E 56th St
#1500
New York, NY 10022
Phone (713) 922-7081

120 E 56th St
Unit 1500
New York, NY 10022
Phone (212) 870-8778

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1144835364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 IRVING PL APT G21B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039708",
            "telephone_number": "713-922-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 56TH ST # 1500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223607",
            "telephone_number": "713-922-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN & AESTHETIC SURGERY OF MANHATTAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "FERN",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "713-922-7081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.

Verify at the official NPI Registry.