Michael Eidelman, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

209980 Issued in NY

Practice address

245 W 19TH St
Ground FL
New York, NY 10011-4072

Phone

(212) 675-0549

Fax

(212) 675-0540

NPI assigned

Nov 16, 2005

Last updated

Mar 17, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Icahn School of Medicine at Mount Sinai, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eidelman Dermatology PLLCGroup PAC ID 8325184500, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eidelman Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1891939575
  Medicare reassignment Care Compare group NPD Authorized official
• Beth Israel Medical Center

  dba Bimc Dermatology Consultants

  • Dermatology Physician
  • New York, NY
  • NPI 1386609535
  NPD (past)
• St Lukes-Roosevelt Hospital Center

  dba Dermatology Associates of SLR

  • Dermatology Physician
  • New York, NY
  • NPI 1831154087
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1689656654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 W 19TH ST",
            "address_2": "GROUND FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114072",
            "telephone_number": "212-675-0549",
            "fax_number": "212-675-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 W 19TH ST",
            "address_2": "GROUND FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114072",
            "telephone_number": "212-675-0549",
            "fax_number": "212-675-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDELMAN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "209980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01998356",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maya Eid, MD/PHD
• Nathalie A Eid, MD
• Emily Kott Eida, M.D.
• Linda Eidelberg, PH.D
• Eidelman Dermatology PLLC
• Nicole Rose Eiden, MD
• Mahyar Eidgah, M.D.
• Laura D'Nell Eidlitz, PHD
• Daniel Eidman, M.D.
• Hannah Eidman

• 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 Mar 17, 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.

Verify at the official NPI Registry.