Individual provider Active NPI

Charisse Allyn Dolitsky, MD

  • Dermatology Physician
  • Long Beach, NY
National Provider Identifier
1477510576
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
168574-1 Issued in NY
Practice address
604 E Park Ave
Long Beach, NY 11561-2505
Phone
(516) 432-0011
Fax
(516) 889-5681
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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 168574-1 NY Primary

Addresses

Primary practice location

604 E Park Ave
Long Beach, NY 11561-2505

Mailing address

604 E Park Ave
Long Beach, NY 11561-2505
Phone (516) 432-0011

Other identifiers 17

IdentifierTypeStateIssuer
7903379002OtherCIGNA
AE01606OtherMDNY
19000OtherMASTERCARE
2C8727OtherHEALTHNET
31F601OtherBCBS
01453456MedicaidNY
019530OtherBETTER HEALTH ADVANTAGE
124428089OtherTRICARE/CHAMPUS
070008112OtherPALMETTO GBA RR MEDICARE
42617OtherVYTRA
P397100OtherOXFORD
010168574NY01OtherANTHEM
0300191OtherUNITED HEALTHCARE
23123OtherGHI
69786OtherUHC EMPIRE PLAN
73594OtherGHI HMO
AETNA/USHEALTHCAREOther112380

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
I20110107001084 NY Practitioner - Dermatology 6709075559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of New York Downstate Medical Center, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Practice addresses (Care Compare)

385 Merrick Rd
Amityville, NY 11701-3420
Phone (212) 283-3000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions916
Removal or shaving of skin growth1-10
Skin biopsy934

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168574-1NYMDDermatology Physician

Networks

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

Organizations & group practices 1

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1477510576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612505",
            "telephone_number": "516-432-0011",
            "fax_number": "516-889-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612505",
            "telephone_number": "516-432-0011",
            "fax_number": "516-889-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLITSKY",
        "first_name": "CHARISSE",
        "middle_name": "ALLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "168574-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7903379002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AE01606",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTERCARE",
            "identifier": "19000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C8727",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31F601",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01453456",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BETTER HEALTH ADVANTAGE",
            "identifier": "019530",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "124428089",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RR MEDICARE",
            "identifier": "070008112",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "42617",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P397100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010168574NY01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0300191",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "23123",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC EMPIRE PLAN",
            "identifier": "69786",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "73594",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "112380",
            "identifier": "AETNA/USHEALTHCARE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.