Individual provider Active NPI

Michele Chun Dehnert, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Staten Island, NY
National Provider Identifier
1851553358
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
286458 Issued in NY
Practice address
584 Forest Ave
Staten Island, NY 10310-2512
Phone
(718) 226-1470
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 286458 NY Primary
Developmental - Behavioral Pediatrics Physician 2080P0006X 25MA09470100 NJ

Addresses

Primary practice location

584 Forest Ave
Staten Island, NY 10310-2512

Mailing address

584 Forest Ave
Staten Island, NY 10310-2512

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161110000830 NY Practitioner - Pediatric Medicine 6901185172 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09470100NJMDDevelopmental - Behavioral Pediatrics Physician
286458NYMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital PC CurrentSince Nov 1, 2016 Accepting new patients
Physicians of University Hospital, PC CurrentSince Nov 1, 2016 Accepting new patients
Physicians of University Hospital, PC Current Accepting new patients
North Shore-Lij Medical PC CurrentSince May 1, 2019 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

584 Forest Ave
Staten Island, NY 10310
Phone (718) 226-5619

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: mdehnert26996@northwell.direct-ci.com

Organizations & group practices 4

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1851553358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102512",
            "telephone_number": "718-226-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHNERT",
        "first_name": "MICHELE",
        "middle_name": "CHUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "286458",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NJ",
            "license": "25MA09470100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.