Active NPI
Alaleh Akhavan, M.D.
- Dermatology Physician
- New York, NY
National Provider Identifier
1205114709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 274564
- Practice address
- 200 W 57TH St
Suite 510
New York, NY 10019-3211 - Phone
- (212) 884-0444
- NPI assigned
- Aug 1, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 274564 | NY | Primary |
Addresses
Primary practice location
200 W 57TH St
Suite 510
New York, NY 10019-3211
Mailing address
200 W 57TH St
Suite 510
New York, NY 10019-3211
Phone (212) 444-8204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390200000X | Other | NY | TAXONOMY NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2021 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 274564 | NY | MD | Dermatology Physician |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1205114709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W 57TH ST",
"address_2": "SUITE 510",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100193211",
"telephone_number": "212-444-8204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W 57TH ST",
"address_2": "SUITE 510",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100193211",
"telephone_number": "212-884-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AKHAVAN",
"first_name": "ALALEH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-01",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "274564",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY NUMBER",
"identifier": "390200000X",
"state": "NY"
}
],
"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 Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.