Individual provider Active NPI

Eric J Fryer, MD

  • Dermatology Physician
  • Bayside, NY
National Provider Identifier
1497856751
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
185911 Issued in NY
Practice address
21008 Northern Blvd
Bayside, NY 11361-3211
Phone
(718) 224-8200
Fax
(718) 819-0244
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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 185911 NY Primary

Addresses

Primary practice location

21008 Northern Blvd
Bayside, NY 11361-3211

Mailing address

21008 Northern Blvd
Bayside, NY 11361-3211
Phone (718) 224-8200

Other identifiers 9

IdentifierTypeStateIssuer
2299670OtherNYGHI
2691300OtherNYAETNA
DS699OtherNYOXFORD
EF02K52220OtherNYEMPIRE BC/BS
010553448OtherNYTHE GUARDIAN
010185911NY02OtherNYANTHEM HEALTH OF NY
4C0917OtherNYHEALTHNET
30804POtherNYHIP OF NY
159125OtherNYELDERPLAN

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
I20120125000493 NY Practitioner - Dermatology 4284787276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Perelman School of Med at the University of Pennsylvania, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fryer Dermatology, PLLCGroup PAC ID 6002706231, 2 clinicians

Practice addresses (Care Compare)

150 Broadhollow Rd
Suite 100
Melville, NY 11747-4901
Phone (631) 673-5700

Merit-based Incentive Payment System (MIPS)

Final score
95.9 of 100Reported as group
Quality
92.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1486
Skin biopsy830

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185911NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fryer Dermatology, PLLC Dermatology CurrentSince Apr 1, 2002 Accepting new patients
Newyork-Presbyterian/Queens Past Accepting new patients

Locations

20801 Northern Blvd
Ste 4F
Bayside, NY 11361
Phone (718) 224-8200

21008 Northern Blvd
Ste 2
Bayside, NY 11361
Phone (718) 224-8200

21008 Northern Blvd
Bayside, NY 11361
Phone (718) 224-8200

150 Broadhollow Rd
Ste 100
Melville, NY 11747
Phone (631) 673-5700

Networks

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

Organizations & group practices 2

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1497856751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21008 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613211",
            "telephone_number": "718-224-8200",
            "fax_number": "718-819-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21008 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613211",
            "telephone_number": "718-224-8200",
            "fax_number": "718-819-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYER",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "185911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2299670",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2691300",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "DS699",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "EF02K52220",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE GUARDIAN",
            "identifier": "010553448",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTH OF NY",
            "identifier": "010185911NY02",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "4C0917",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP OF NY",
            "identifier": "30804P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERPLAN",
            "identifier": "159125",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.