Active NPI
Charlotte S Noorollah, D.O.
- Dermatology Physician
- Roslyn Heights, NY
National Provider Identifier
1194040378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 250554
- Practice address
- 87 Barnyard LN
Roslyn Heights, NY 11577-2808 - Phone
- (718) 869-7000
- NPI assigned
- Mar 31, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 250554 | NY | Primary |
Addresses
Primary practice location
87 Barnyard LN
Roslyn Heights, NY 11577-2808
Mailing address
125 E 87TH St Apt 12C
New York, NY 10128-1128
Phone (718) 869-7000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140314000761 | NY | Practitioner - Dermatology | 7214168210 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
220 Front St
New York, NY 10038-2033
Phone (212) 385-3700
Hospital & facility affiliations
- Mount Sinai Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 125 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 36 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 250554 | NY | MD | Dermatology Physician |
Practice roles (6 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology, Laser and Surgery of Flatiron PLLC | Dermatology | Current | Accepting new patients |
| Derm Specs of PA PLLC | Dermatology | Current | Accepting new patients |
| Dennis a Porto MD PLLC | Dermatology | Past | Accepting new patients |
| Out East Medical | Dermatology | Past | Accepting new patients |
| Mount Sinai Hospital | Past | Accepting new patients | |
| Atlas Infectious Disease Practice PLLC | Past | Accepting new patients |
Locations
1027 46th Ave
Fl 1
Long Island City, NY 11101
928 Broadway
Ste 204
New York, NY 10010
Phone (212) 982-8229
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dermatology Physician
- New York, NY
- NPI 1699287839
Dermatology
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- Infectious Disease Physician
- Atlantis, FL
- NPI 1326655846
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563926400000",
"number": "1194040378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 E 87TH ST APT 12C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101281128",
"telephone_number": "718-869-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 BARNYARD LN",
"city": "ROSLYN HEIGHTS",
"state": "NY",
"postal_code": "115772808",
"telephone_number": "718-869-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOOROLLAH",
"first_name": "CHARLOTTE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-31",
"last_updated": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "250554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslyn Heights, NY
- New York Bariatric Surgery Group PLLC
- Seth Andrew Newman, D.D.S.
- Desarie Nicholas, LCSW
- Carol R Noble, PH.D.
- Megan Nolan, LCSW
- North Shore Child and Family Guidance Association Incorporated
- North Shore Contact Lens & Vision Consultants PC
- North Shore Counseling and LCSW Services PC
- North Shore Geriatric Psychiatry
- North Shore Learning
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.