Individual provider Active NPI

Lewis M. Feder, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1679630370
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
103672 Issued in NY
Practice address
965 Fifth Avenue
Suite 1B
New York, NY 10075
Phone
(212) 535-8700
Fax
(646) 553-5644
NPI assigned
Jan 2, 2007
Last updated
Apr 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 103672-1 NY
Dermatology Physician 207N00000X 103672 NY Primary

Addresses

Primary practice location

965 Fifth Avenue
Suite 1B
New York, NY 10075

Mailing address

965 Fifth Avenue
Suite 1B
New York, NY 10075
Phone (212) 535-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103672NYMDSocial Worker
103672-1NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1679630370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 FIFTH AVENUE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10075",
            "telephone_number": "212-535-8700",
            "fax_number": "646-553-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 FIFTH AVENUE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10075",
            "telephone_number": "212-535-8700",
            "fax_number": "646-553-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDER",
        "first_name": "LEWIS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "103672-1",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "103672",
            "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 Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.