NPIMap

Organization Active NPI

Century Dermatology PC

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1285231506
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CENTURY DERMATOLOGY PC
Practice address
5604 7TH Ave Ste 1
Brooklyn, NY 11220-4660
Phone
(718) 450-8918
Fax
(718) 450-8919
NPI assigned
Oct 8, 2020
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Dr. Elena Pollack, MDNPI 1366711350
Title
Owner
Phone
(718) 820-6091

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 NU Primary

Addresses

Primary practice location

5604 7TH Ave Ste 1
Brooklyn, NY 11220-4660

Mailing address

5604 7TH Ave Ste 1
Brooklyn, NY 11220-4660
Phone (718) 450-8918

Other practice location 1

2691 Hylan Blvd Ste 6
Staten Island, NY 10306-4300
Phone (347) 973-6888

Other practice location 2

1927 86th St Apt 1
Brooklyn, NY 11214-3153
Phone (347) 519-6888

Other identifiers 1

IdentifierTypeStateIssuer
01890808MedicaidNY

Other names 1

  • Pollack Dermatology PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210302001761 NY Part B Supplier - Clinic/Group Practice 1557776739 Receives reassigned benefits from 9 practitioners
Practice locations: Brooklyn, NY; New York, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

5604 7th Ave
Ste 1
Brooklyn, NY 11220
Phone (718) 360-7666

1766 Hylan Blvd
Unit B
Staten Island, NY 10305
Phone (347) 973-6888

2691 Hylan Blvd
Ste 6
Staten Island, NY 10306
Phone (347) 973-6888

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1285231506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 7TH AVE STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204660",
            "telephone_number": "718-450-8918",
            "fax_number": "718-450-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 7TH AVE STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204660",
            "telephone_number": "718-450-8918",
            "fax_number": "718-450-8919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2691 Hylan Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103064300",
            "country_code": "US",
            "telephone_number": "347-973-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1927 86th St Apt 1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143153",
            "country_code": "US",
            "telephone_number": "347-519-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTURY DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2023-04-03",
        "certification_date": "2020-11-27",
        "status": "A",
        "authorized_official_last_name": "POLLACK",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-820-6091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01890808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pollack Dermatology PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.