Individual provider Active NPI

Francis W. Iacobellis, MD

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1386620631
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
114091-1 Issued in NY
Practice address
125 E 63Rd St Unit 1BC
New York, NY 10065-7302
Phone
(212) 661-3376
Fax
(212) 661-3366
NPI assigned
Dec 19, 2005
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 114091-1 NY Primary
Dermatology Physician 207N00000X ME132341 FL

Addresses

Primary practice location

125 E 63Rd St Unit 1BC
New York, NY 10065-7302

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172
Phone (407) 875-2080

Other practice location 1

153 E 88th St
New York, NY 10128-2270
Phone (212) 289-8600

Other identifiers 18

IdentifierTypeStateIssuer
114019OtherNYCONNECTICARE
133884168OtherNYHORIZON HEALTHCARE OF NY
173187POtherNYHIP
070011868OtherNYRAILROAD MEDICARE
133884168OtherNYUNITED HEALTH CARE
133884168OtherNYPOMCO
13U231OtherNYBLUE CROSS HMO
0250055MedicaidNY
696790OtherNYPHCS
133884168OtherNYMULTIPLAN
317283OtherNYBLUE CROSS PPO
3C1366OtherNYHEALTHNET
133884168OtherNYEMPIRE STATE PLAN (NYS)
2132222OtherNYAETNA HMO
4220508OtherNYAETNA NON HMO
000000045835OtherNYGHI HMO
133884168OtherNYBEECH STREET
P942741OtherNYOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120113000252 NY Practitioner - Dermatology 9638104722 Reassigns benefits to 2 organizations
Practice locations: New York, NY
I20200108001139 FL Practitioner - Dermatology 9638104722 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Columbia School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

801 N Orange Ave
Suite 520
Orlando, FL 32801-5202
Phone (407) 992-0660

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions392
Removal or shaving of skin growth1-10
Skin biopsy154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114091-1NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Dec 10, 2024 Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Dec 10, 2024 Accepting new patients
Water's Edge Dermatology, LLC Dermatology CurrentSince Jan 2, 2020 Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
J Matthew Knight M D P a CurrentSince Oct 1, 2023 Accepting new patients
Manhattan Dermatology and Cosmetics PLLC Dermatology CurrentSince Jun 1, 2020 Accepting new patients
Water's Edge Dermatology, LLC CurrentSince Jan 2, 2020 Accepting new patients
David E. Bank, M.D., P.C. Dermatology CurrentSince Oct 18, 2012 Accepting new patients
Leavitt Medical Associates of Florida Inc Dermatology PastSince Jun 1, 2021 Accepting new patients
Pariser Dermatology Specialists LTD Dermatology Past Accepting new patients
Leavitt Medical Associates of Florida Inc Dermatology PastSince Jun 1, 2021 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

1035 Primera Blvd
Ste 1041
Lake Mary, FL 32746
Phone (407) 992-0660

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3200 N Wickham Rd
Ste 5
Melbourne, FL 32935
Phone (407) 992-0660

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

801 N Orange Ave
Ste 520
Orlando, FL 32801
Phone (407) 992-0660

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

600 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

2202 State Ave
Ste 102
Panama City, FL 32405
Phone (850) 250-5790

540 Fontaine St
Pensacola, FL 32503
Phone (800) 243-7546

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

1901 Lee Rd
Winter Park, FL 32789
Phone (407) 647-7300

359 E Main St
#4
Mount Kisco, NY 10549
Phone (314) 241-3003

820 2nd Ave
Rm 3A
New York, NY 10017
Phone (212) 661-3376

Interoperability endpoints

  • Direct secure messaging: francis.iacobellis@forefrontdermatology.emadirect.md

Organizations & group practices 12

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1386620631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "076-503-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 63RD ST UNIT 1BC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657302",
            "telephone_number": "212-661-3376",
            "fax_number": "212-661-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 E 88th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101282270",
            "country_code": "US",
            "telephone_number": "212-289-8600",
            "fax_number": "212-289-8813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACOBELLIS",
        "first_name": "FRANCIS",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "114091-1",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME132341",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "114019",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON HEALTHCARE OF NY",
            "identifier": "133884168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "173187P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070011868",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "133884168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "POMCO",
            "identifier": "133884168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS HMO",
            "identifier": "13U231",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250055",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "696790",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "133884168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PPO",
            "identifier": "317283",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3C1366",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE STATE PLAN (NYS)",
            "identifier": "133884168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2132222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "4220508",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "000000045835",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "133884168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P942741",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.