Jason S. Applebaum, MD, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JASON S. APPLEBAUM, MD, PC

Practice address

500 N Broadway
Jericho, NY 11753-2127

Phone

(917) 696-3954

Fax

(812) 461-0425

NPI assigned

Sep 29, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jason Applebaum, MDNPI 1447251129

Title

Director

Phone

(917) 696-3923

Specialties & licenses 1

Addresses

Other names 1

• shade dermatology Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Applebaum, MD

  • Dermatology Physician
  • Fresh Meadows, NY
  • NPI 1447251129
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1295459501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CLOVER DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211030",
            "fax_number": "812-461-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BROADWAY",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532127",
            "telephone_number": "917-696-3954",
            "fax_number": "812-461-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON S. APPLEBAUM, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "APPLEBAUM",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-696-3923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ehr",
            "affiliation": "N",
            "endpointDescription": "ehr",
            "address_1": "500 N Broadway",
            "city": "Jericho",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117532127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "shade dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ilan Israeli, M.D.
• Ronit Istad, DDS
• Jack Casale D.D.S., P.C.
• Irtaqua Jamil
• Naomi Jankowitz, LCSW
• Jay M. Weiss MD P.C.
• Yoonjin Jee, LCSW, CASAC
• Mary Dale Jenkins, MD
• Michelle Ahn Jeong
• Jericho Fire District

• Dermatology Physician in Jericho, NY
• Providers in Jericho, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.