Individual provider Active NPI

Justine Fenner Biederman, MD

  • Pediatric Dermatology Physician
  • New York, NY
National Provider Identifier
1376040469
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
321561 Issued in NY
Practice address
5 E 98TH St
New York, NY 10029-6501
Phone
(212) 241-9728
NPI assigned
Apr 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 321561 NY
Student in an Organized Health Care Education/Training Program 390200000X NY
Pediatric Dermatology Physician 207NP0225X 321561 NY Primary

Addresses

Primary practice location

5 E 98TH St
New York, NY 10029-6501

Mailing address

8 Buckingham Dr
Dix Hills, NY 11746-5410

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
I20230418002288 NY Practitioner - Dermatology 8921473240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave Levy Place
New York, NY 10029-6500
Phone (212) 241-8234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
321561NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Dermatology CurrentSince May 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

533 W 57th St
Fl 6
New York, NY 10019
Phone (646) 493-1588

10 Union Sq E
Ste 4J
New York, NY 10003
Phone (212) 844-6949

150 E 42nd St
Fl 2
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

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

Interoperability endpoints

  • Direct secure messaging: adv9023@direct.nyp.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1376040469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BUCKINGHAM DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIEDERMAN",
        "first_name": "JUSTINE",
        "middle_name": "FENNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "321561",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NY",
            "license": "321561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.