Individual provider Active NPI

Kiran Mian, D.O.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1942681200
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
714 Issued in IL
Practice address
12 W 21St St FL 6
New York, NY 10010-6914
Phone
(212) 343-2222
NPI assigned
Jun 12, 2015
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 714 IL Primary

Addresses

Primary practice location

12 W 21St St FL 6
New York, NY 10010-6914

Mailing address

483 10 Avenue
Suite 310
New York, NY 10018
Phone (917) 970-9100

Other identifiers 2

IdentifierTypeStateIssuer
714OtherILLICENSE
294165-1OtherNYMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drmian@flatironfamily.com Direct

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
I20190227000644 NY Practitioner - Dermatology 3870896368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rowan University School of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DB Dermatology PLLCGroup PAC ID 1759623531, 4 clinicians

Practice addresses (Care Compare)

483 10TH Ave
RM 310
New York, NY 10018-9737
Phone (917) 970-9100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
714ILMDDermatology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1942681200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 10 AVENUE",
            "address_2": "SUITE 310",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10018",
            "telephone_number": "917-970-9100",
            "fax_number": "917-970-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W 21ST ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106914",
            "telephone_number": "212-343-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIAN",
        "first_name": "KIRAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "714",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "294165-1",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmian@flatironfamily.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "text",
            "address_1": "12 W 21st St Fl 6",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100106914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.