NPIMap

Organization Active NPI

Atlantic Dermatologic Associates, LLP

  • Specialist
  • Lynbrook, NY
National Provider Identifier
1447264387
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
146498-1 Issued in NY
Legal business name
ATLANTIC DERMATOLOGIC ASSOCIATES, LLP
Practice address
444 Merrick Rd Ste LL2
Lynbrook, NY 11563-2400
Phone
(516) 599-4242
Fax
(516) 599-4449
NPI assigned
Jul 28, 2006
Last updated
Dec 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Dr. Marvin Brian Tankel, M.D.NPI 1700885290
Title
Partner
Phone
(516) 599-4242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 146498-1 NY Primary

Addresses

Primary practice location

444 Merrick Rd Ste LL2
Lynbrook, NY 11563-2400

Mailing address

444 Merrick Rd Ste LL2
Lynbrook, NY 11563-2400
Phone (516) 599-4498

Other identifiers 1

IdentifierTypeStateIssuer
02559575MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000929 NY Part B Supplier - Clinic/Group Practice 8022900869 Receives reassigned benefits from 12 practitioners
Practice locations: Lynbrook, NY; Howard Beach, NY; Brooklyn, NY; Bellmore, NY

National Provider Directory

National Provider Directory

Locations

2270 Kimball St
Ste 201
Brooklyn, NY 11234
Phone (718) 253-4550

266 Merrick Rd
Ste 201
Lynbrook, NY 11563
Phone (516) 599-4242

30 S Central Ave
Ste 201
Valley Stream, NY 11580
Phone (516) 791-8664

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1447264387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MERRICK RD STE LL2",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632400",
            "telephone_number": "516-599-4498",
            "fax_number": "516-599-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MERRICK RD STE LL2",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632400",
            "telephone_number": "516-599-4242",
            "fax_number": "516-599-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC DERMATOLOGIC ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "TANKEL",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "516-599-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "146498-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02559575",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.