Individual provider Active NPI

Isabella Ilarda, MD

  • Dermatology Physician
  • Middle Village, NY
National Provider Identifier
1982619318
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
206401 Issued in NY
Practice address
78-12 Metropolitan Ave
New Age Dermatology
Middle Village, NY 11379-2900
Phone
(718) 416-4600
Fax
(718) 416-4603
NPI assigned
Jul 31, 2006
Last updated
Oct 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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 206401 NY Primary

Addresses

Primary practice location

78-12 Metropolitan Ave
New Age Dermatology
Middle Village, NY 11379-2900

Mailing address

78-12 Metropolitan Ave
New Age Dermatology
Middle Village, NY 11379-2900
Phone (718) 416-4600

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
I20040706000818 NY Practitioner - Dermatology 2163409335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of Ny Upstate Medical University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6112 69TH St
Middle Village, NY 11379-1142
Phone (718) 416-4600

Merit-based Incentive Payment System (MIPS)

Final score
93.72 of 100Reported as individual
Quality
88.58
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions264
Removal of nail tissue1-10
Skin biopsy566

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Isabella Ilarda M.D., P.C. Dermatology CurrentSince Jan 21, 2009 Accepting new patients
Khawaja Ali Hassan, Physician, PC Past Accepting new patients
New Age Dermatology PLLC PastSince Sep 1, 2006 Accepting new patients
Hope Medical Services PC PastSince Jun 1, 2014 Accepting new patients
Schweiger Dermatology PLLC Dermatology PastSince Jan 1, 2017 Accepting new patients

Locations

6112 69th St
Apt P2
Middle Vlg, NY 11379
Phone (718) 416-4600

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: isabella@ilardamd.emadirect.md
  • Direct secure messaging: isi9002@direct.nyp.org

Organizations & group practices 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1982619318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78-12 METROPOLITAN AVE",
            "address_2": "NEW AGE DERMATOLOGY",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792900",
            "telephone_number": "718-416-4600",
            "fax_number": "718-416-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78-12 METROPOLITAN AVE",
            "address_2": "NEW AGE DERMATOLOGY",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792900",
            "telephone_number": "718-416-4600",
            "fax_number": "718-416-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILARDA",
        "first_name": "ISABELLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "206401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

Verify at the official NPI Registry.