Hennessey Dermatology LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

133471 Issued in NY

Legal business name

HENNESSEY DERMATOLOGY LLC

Practice address

161 Madison Ave RM 6SE
New York, NY 10016-5454

Phone

(212) 677-5555

Fax

(212) 677-5558

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

N Patrick Hennessey, M.D.

Title

Physician

Phone

(212) 677-5555

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

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

• N Patrick Hennessey, M.D.

  • Specialist
  • New York, NY
  • NPI 1285694661
  Medicare reassignment NPD
• Alyssa Gopman, PA

  • Medical Physician Assistant
  • New York, NY
  • NPI 1669870325
  NPD (past)
• Jennifer L Kallio, PA-C

  • Physician Assistant
  • Reston, VA
  • NPI 1528022001
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1790818623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MADISON AVE RM 6SE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165454",
            "telephone_number": "212-677-5555",
            "fax_number": "212-677-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MADISON AVE RM 6SE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165454",
            "telephone_number": "212-677-5555",
            "fax_number": "212-677-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNESSEY DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "HENNESSEY",
        "authorized_official_first_name": "N PATRICK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "212-677-5555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "133471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Henn-Haase, PSY.D.
• Lindsey Hennawi, LCSW
• Michael Henne, ATC
• Carolyn Ann Hennecken, MD
• Jasmine A Hennep, LMHC
• Benet Hennessey, MA, EDM, LMHC
• Catherine Anne Hennessey, MD
• Jessica A Hennessey, MD, PHD
• N Patrick Hennessey, M.D.
• Hennessy Pta PLLC

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.