Individual provider Active NPI

Theresa Durchhalter, D.O.

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1427419241
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
290730 Issued in NY
Practice address
7901 4TH Ave
Brooklyn, NY 11209-3972
Phone
(718) 491-5800
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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 290730 NY Primary

Addresses

Primary practice location

7901 4TH Ave
Brooklyn, NY 11209-3972

Mailing address

998 Third Ave
Franklin Square, NY 11010-1846
Phone (516) 640-1336

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
I20200508001068 NY Practitioner - Dermatology 6709217680 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allure Dermatology PLLCGroup PAC ID 3274929468, 4 clinicians

Practice addresses (Care Compare)

400 S Oyster Bay Rd
Suite 100
Hicksville, NY 11801-3500
Phone (516) 933-1717

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as group
Quality
96.29
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16
Removal of skin lesions600
Removal or shaving of skin growth35
Skin biopsy246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290730NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald R Brancaccio MD & Peter Saitta DO PC Dermatology CurrentSince Jul 1, 2020 Accepting new patients
Saitta Dermatology PC Dermatology CurrentSince Jul 1, 2020 Accepting new patients
Charles Evans Center, Inc. CurrentSince Mar 26, 2024 Accepting new patients
Mariel Eliza, M.D., PLLC CurrentSince May 1, 2022 Accepting new patients
St John'S Medical Services PC CurrentSince May 4, 2022 Accepting new patients
Allure Dermatology PLLC Dermatology CurrentSince May 1, 2022 Accepting new patients
Charles Evans Center, Inc CurrentSince Mar 26, 2024 Accepting new patients

Locations

857 S Oyster Bay Rd
Bethpage, NY 11714
Phone (516) 622-8888

7901 4th Ave
Ste A20
Brooklyn, NY 11209
Phone (718) 491-6900

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

340 Dogwood Ave
Ste 109
Franklin Square, NY 11010
Phone (516) 483-0800

400 S Oyster Bay Rd
Ste 100
Hicksville, NY 11801
Phone (516) 234-0073

10538 Rockaway Beach Blvd
Rockaway Park, NY 11694
Phone (718) 318-3434

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1427419241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 THIRD AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101846",
            "telephone_number": "516-640-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093972",
            "telephone_number": "718-491-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURCHHALTER",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "290730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.