Active NPI
Charisse Allyn Dolitsky, MD
- Dermatology Physician
- Long Beach, NY
National Provider Identifier
1477510576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 168574-1
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7903379002 | Other | CIGNA | |
| AE01606 | Other | MDNY | |
| 19000 | Other | MASTERCARE | |
| 2C8727 | Other | HEALTHNET | |
| 31F601 | Other | BCBS | |
| 01453456 | Medicaid | NY | |
| 019530 | Other | BETTER HEALTH ADVANTAGE | |
| 124428089 | Other | TRICARE/CHAMPUS | |
| 070008112 | Other | PALMETTO GBA RR MEDICARE | |
| 42617 | Other | VYTRA | |
| P397100 | Other | OXFORD | |
| 010168574NY01 | Other | ANTHEM | |
| 0300191 | Other | UNITED HEALTHCARE | |
| 23123 | Other | GHI | |
| 69786 | Other | UHC EMPIRE PLAN | |
| 73594 | Other | GHI HMO | |
| AETNA/USHEALTHCARE | Other | 112380 |
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
Enrollment records 1
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
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 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 916 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 934 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 168574-1 | NY | MD | Dermatology 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.
-
- Dermatology Physician
- New York, NY
- NPI 1831438662
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.