NPIMap

Organization Active NPI

David a. Colbert M.D., P.C.

Doing business as New York Dermatology Group

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1932355732
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DAVID A. COLBERT M.D., P.C.
Doing business as
New York Dermatology Group
Practice address
119 5TH Ave
4TH Floor
New York, NY 10003-1007
Phone
(212) 533-8888
Fax
(212) 673-5185
NPI assigned
Aug 12, 2008
Last updated
Aug 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Authorized official

Name
Nancy Fonseca
Title
Claims Manager
Phone
(646) 442-5002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

119 5TH Ave
4TH Floor
New York, NY 10003-1007

Mailing address

119 5TH Ave
4TH Floor
New York, NY 10003-1007
Phone (212) 533-8888

Other names 1

  • New York Dermatology Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100107000350 NY Part B Supplier - Clinic/Group Practice 1456302199 Receives reassigned benefits from 8 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1932355732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 5TH AVE",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031007",
            "telephone_number": "212-533-8888",
            "fax_number": "212-673-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 5TH AVE",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031007",
            "telephone_number": "212-533-8888",
            "fax_number": "212-673-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A. COLBERT M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CLAIMS MANAGER",
        "authorized_official_telephone_number": "646-442-5002"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Dermatology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.