Iris Dubetsky, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MP000333 Issued in NJ

Practice address

2510 Belmar Blvd Ste I-1
Wall, NJ 07719-3983

Phone

(609) 495-8644

Fax

(908) 520-4216

NPI assigned

Nov 9, 2006

Last updated

Dec 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Dermatology Associates of Central New Jersey, PA

  • MOHS-Micrographic Surgery Physician
  • Old Bridge, NJ
  • NPI 1104950013
  Medicare reassignment
• Modern Dermatology and Cosmetic Center LLC

  • Dermatology Physician
  • Wall, NJ
  • NPI 1376230581
  Medicare reassignment
• New Jersey Dermatology and Aesthetics Center LLC

  • Dermatology Physician
  • Marlboro, NJ
  • NPI 1780178871
  Medicare reassignment
• Dermatology Center of North Jersey

  • Specialist
  • Clifton, NJ
  • NPI 1326141110
  NPD (past)
• Shonta D Collins Consulting Group LLC

  • Nurse Practitioner
  • Old Bridge, NJ
  • NPI 1144797416
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1194895649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 BELMAR BLVD STE I-1",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "077193983",
            "telephone_number": "609-495-8644",
            "fax_number": "908-520-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BELMAR BLVD STE I-1",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "077193983",
            "telephone_number": "609-495-8644",
            "fax_number": "908-520-4216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Throckmorton Ln",
            "address_2": "suite 204",
            "address_purpose": "LOCATION",
            "city": "Old Bridge",
            "state": "NJ",
            "postal_code": "088572558",
            "country_code": "US",
            "telephone_number": "732-679-6300",
            "fax_number": "732-679-9566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBETSKY",
        "first_name": "IRIS",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "MP000333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie D'Allura
• Dallura Eye Care
• Debra S Gluck MSW LCSW LLC
• Anthony Defazio, MA
• Digital Diagnostics, Inc.
• Easter Seals New Jersey
• Easter Seals New Jersey
• Carrie A Edelman, M.D.
• Charles Elmendorf
• Embracing Hospicecare of New Jersey,LLC

• Physician Assistant in Wall, NJ
• Providers in Wall, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.

Verify at the official NPI Registry.