Shereene Idriss, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

269568 Issued in NY

Practice address

Idriss Dermatology
80 W 40TH St, 3Rd Floor
New York, NY 10018-2682

Phone

(212) 612-1520

Fax

(332) 216-3520

NPI assigned

May 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2016 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Union Square Laser Dermatology

  • Procedural Dermatology Physician
  • New York, NY
  • NPI 1487936308

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1295969624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W 40TH ST",
            "address_2": "FLOOR 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182682",
            "telephone_number": "212-612-1520",
            "fax_number": "332-216-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IDRISS DERMATOLOGY",
            "address_2": "80 W 40TH ST, 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182682",
            "telephone_number": "212-612-1520",
            "fax_number": "332-216-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRISS",
        "first_name": "SHEREENE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "269568-1",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "269568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sana Idnani
• Caitlin Idoine
• Sarah Idowu
• Teniola Idowu
• Idox Inc.
• Iduha Ipa LLC
• Osamuyimen Elizabeth Idusogie
• Iea Chelsea LLC
• Rosemarie Elizabeth Ieda, LCSW-R
• Iefa LLC

• Dermatology Physician in New York, NY
• Providers in New York, 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 Jun 23, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.