New York Dermatology, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

168660 Issued in NY

Legal business name

NEW YORK DERMATOLOGY, PC

Practice address

2383 Bell Blvd
Bayside, NY 11360-2053

Phone

(718) 423-0200

Fax

(718) 423-3134

NPI assigned

Jan 9, 2008

Last updated

Mar 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jordan Spence Zuckerman, MDNPI 1043205016

Title

Medical Director

Phone

(718) 423-0200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12622/brand/1/csg/1/fhir/r4

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jordan Spence Zuckerman, M.D.

  • Procedural Dermatology Physician
  • Bayside, NY
  • NPI 1043205016
  Medicare reassignment Care Compare group NPD Authorized official
• Todd R. Coven, M.D.

  • MOHS-Micrographic Surgery Physician
  • Huntington Station, NY
  • NPI 1215943121
  Medicare reassignment Care Compare group NPD
• Xuan Wang, M.D. PH.D.

  • Anatomic Pathology Physician
  • Woodbury, NY
  • NPI 1578706032
  Medicare reassignment Care Compare group NPD
• Matthew Brett Quan, M.D.

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1578535910
  NPD (past)
• Michael Edward Ford, O.D.

  • Optometrist
  • Martinsville, VA
  • NPI 1922008952
  NPD (past)

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1881879773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2383 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602053",
            "telephone_number": "718-423-0200",
            "fax_number": "718-423-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2383 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602053",
            "telephone_number": "718-423-0200",
            "fax_number": "718-423-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "ZUCKERMAN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "SPENCE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-423-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "168660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Nesi, LMSW
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• New Path Services Corporation
• New Standards Physical Therapy, PC
• New York Core Chiropractic P.C.
• New York Dialysis Services, Inc. (Bayside Dialysis Center)
• New York Medical Office Based Surgery PC
• New York Physical Therapy Sports Rehabilitation PLLC
• New York Psychological Wellness, PC
• New York Speech-Language Pathology, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.