Active NPI
Robert Trail Horn Jr., MD
- Dermatology Physician
- Ithaca, NY
National Provider Identifier
1922083641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 120622
- Practice address
- 2333 N Triphammer Rd
Ste 203
Ithaca, NY 14850-1082 - Phone
- (607) 257-1107
- Fax
- (607) 257-1867
- NPI assigned
- Dec 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 120622 | NY | Primary |
Addresses
Primary practice location
2333 N Triphammer Rd
Ste 203
Ithaca, NY 14850-1082
Mailing address
12 Bolton Point Rd
Ithaca, NY 14850-9778
Phone (607) 273-5690
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00781571 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Associates of Ithaca, LLC | Dermatology | Past | Accepting new patients |
| Robert T. Horn, Jr., M.D. | Dermatology | Past | Accepting new patients |
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.
-
- Dermatology Physician
- Ithaca, NY
- NPI 1396062121
-
- Dermatology Physician
- Ithaca, NY
- NPI 1609170992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1922083641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 BOLTON POINT RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509778",
"telephone_number": "607-273-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 N TRIPHAMMER RD",
"address_2": "STE 203",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501082",
"telephone_number": "607-257-1107",
"fax_number": "607-257-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORN",
"first_name": "ROBERT",
"middle_name": "TRAIL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "120622",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00781571",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.