NPIMap

Organization Active NPI

Allure Dermatology PLLC

  • Dermatology Physician
  • Hicksville, NY
National Provider Identifier
1932853728
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ALLURE DERMATOLOGY PLLC
Practice address
400 S Oyster Bay Rd Ste 100
Hicksville, NY 11801-3500
Phone
(516) 592-3000
Fax
(516) 933-6851
NPI assigned
Feb 9, 2022
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Theresa Durchhalter, DONPI 1427419241
Title
Owner
Phone
(516) 594-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

400 S Oyster Bay Rd Ste 100
Hicksville, NY 11801-3500

Mailing address

178 Berryhill CT
West Hempstead, NY 11552-1504
Phone (516) 492-6130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220418000358 NY Part B Supplier - Clinic/Group Practice 3274929468 Receives reassigned benefits from 6 practitioners
Practice locations: Franklin Square, NY; Hicksville, NY

National Provider Directory

National Provider Directory

Locations

340 Dogwood Ave
Ste 109
Franklin Square, NY 11010
Phone (516) 483-0800

Practitioners & affiliated clinicians

Practitioners 8

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": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1932853728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 BERRYHILL CT",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115521504",
            "telephone_number": "516-492-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD STE 100",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-592-3000",
            "fax_number": "516-933-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLURE DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "DURCHHALTER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-594-3000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.