Organization Active NPI

Ellen C. Gendler, M.D., P.C.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1659573293
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
150962 Issued in NY
Legal business name
ELLEN C. GENDLER, M.D., P.C.
Practice address
1035 5TH Ave
New York, NY 10028-0135
Phone
(212) 288-8222
Fax
(212) 988-9640
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ellen Caryn Gendler, M.D.
Title
President
Phone
(212) 288-8222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 150962 NY Primary

Addresses

Primary practice location

1035 5TH Ave
New York, NY 10028-0135

Mailing address

1035 5TH Ave
New York, NY 10028-0135
Phone (212) 288-8222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191220001833 NY Part B Supplier - Clinic/Group Practice 6800220096 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659573293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280135",
            "telephone_number": "212-288-8222",
            "fax_number": "212-988-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280135",
            "telephone_number": "212-288-8222",
            "fax_number": "212-988-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN C. GENDLER, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENDLER",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "CARYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-288-8222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "150962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.