21St Century Dermatology, P.L.L.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

231240 Issued in NY

Legal business name

21ST CENTURY DERMATOLOGY, P.L.L.C.

Practice address

133 E 58TH St
Suite 502
New York, NY 10022-1236

Phone

(212) 644-4440

Fax

(212) 644-4447

NPI assigned

Jan 30, 2009

Last updated

Jan 30, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jessica Diaz

Title

Billing Manager

Phone

(646) 576-5688

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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.

• Robin Michelle Rubell, MD

  • Dermatology Physician
  • New York, NY
  • NPI 1821151747
  Medicare reassignment NPD

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1558509448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "SUITE 502",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-644-4440",
            "fax_number": "212-644-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "SUITE 502",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-644-4440",
            "fax_number": "212-644-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY DERMATOLOGY, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "646-576-5688",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "231240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.