Individual provider Active NPI

Bradley Glodny, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1326347766
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
268803 Issued in NY
Practice address
580 Park Avenue
Suite 1
New York, NY 10065
Phone
(212) 752-3692
Fax
(212) 838-5636
NPI assigned
Mar 24, 2011
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 268803 NY Primary

Addresses

Primary practice location

580 Park Avenue
Suite 1
New York, NY 10065

Mailing address

580 Park Avenue
Suite 1
New York, NY 10065
Phone (212) 752-3692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008001346 NY Practitioner - Dermatology 6507174703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complexion Medical PLLCGroup PAC ID 9032585948, 3 clinicians

Practice addresses (Care Compare)

580 Park Ave
Suite 1
New York, NY 10065-7313
Phone (212) 752-3692

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions442
Removal or shaving of skin growth1-10
Skin biopsy56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Complexion Medical PLLC Dermatology CurrentSince Jul 1, 2022 Accepting new patients
Adam Geyer MD PC Dermatology CurrentSince Jul 15, 2015 Accepting new patients
Paru Chaudhari MD PLLC PastSince Mar 17, 2013 Accepting new patients

Locations

32 Ericsson Pl
New York, NY 10013
Phone (212) 374-9750

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1326347766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 PARK AVENUE",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-752-3692",
            "fax_number": "212-838-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PARK AVENUE",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-752-3692",
            "fax_number": "212-838-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLODNY",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "268803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.