Individual provider Active NPI

Ella Glaser, MD

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1841852647
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
322708 Issued in NY
Practice address
130 E 18TH St Lbby 1U
New York, NY 10003-2416
Phone
(212) 674-0004
Fax
(917) 677-8525
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 322708 NY Primary

Addresses

Primary practice location

130 E 18TH St Lbby 1U
New York, NY 10003-2416

Mailing address

39 E 29TH St Apt 19a
New York, NY 10016-7952
Phone (314) 440-1551

Other practice location 1

1425 2nd Ave
New York, NY 10021-3304
Phone (212) 385-3700

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190821001087 MO Order and Referring Only - DermatologyPractitioner - DermatologyPractitioner - Physical Medicine and Rehabilitation 5799013322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322708NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mack Dermatology, P.C. CurrentSince May 1, 2015 Accepting new patients
Bobby Buka, M.D., P.C. Dermatology PastSince Feb 23, 2026 Accepting new patients

Locations

130 E 18th St
Lbby 1U
New York, NY 10003
Phone (212) 420-0425

1 Palmer Ave
Ste 201
Scarsdale, NY 10583
Phone (212) 674-0004

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1841852647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 E 29TH ST APT 19A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167952",
            "telephone_number": "314-440-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 18TH ST LBBY 1U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032416",
            "telephone_number": "212-674-0004",
            "fax_number": "917-677-8525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100213304",
            "country_code": "US",
            "telephone_number": "212-385-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASER",
        "first_name": "ELLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "322708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.