NPIMap

Organization Active NPI

Catskill Dermatology, PC

  • Dermatology Physician
  • Monticello, NY
National Provider Identifier
1235279233
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
191489 Issued in NY
Legal business name
CATSKILL DERMATOLOGY, PC
Practice address
110 Bridgeville Rd
Monticello, NY 12701
Phone
(845) 794-3030
Fax
(845) 794-3036
NPI assigned
Feb 7, 2007
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Steven J Fishman, MDNPI 1528016540
Title
Owner
Phone
(845) 794-3030

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
Dermatology Physician 207N00000X 191489 NY Primary

Addresses

Primary practice location

110 Bridgeville Rd
Monticello, NY 12701

Mailing address

110 Bridgeville Rd.
Monticello, NY 12701
Phone (845) 794-3030

Other identifiers 4

IdentifierTypeStateIssuer
2K5763OtherNYBCBS
N3955OtherNYRAILROAD MEDICARE
01429941OtherNYMEDICAID
2K5762OtherNYBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070531000123 NY Part B Supplier - Clinic/Group Practice 2466550397 Receives reassigned benefits from 13 practitioners
Practice locations: Southampton, NY; Monticello, NY; Goshen, 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
33D0870907Catskill Dermatology PC110 Bridgeville Road, Monticello, NY 12701ComplianceJul 1, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1235279233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BRIDGEVILLE RD.",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "12701",
            "telephone_number": "845-794-3030",
            "fax_number": "845-794-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BRIDGEVILLE RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "12701",
            "telephone_number": "845-794-3030",
            "fax_number": "845-794-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATSKILL DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "FISHMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-794-3030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "191489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2K5763",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "N3955",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "01429941",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2K5762",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.