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EASTBAY MEDICAL PC
NPI 1063272474
Dermatology in Bellmore, NY

Active since March 21, 2024
2307 BELLMORE AVE, BELLMORE, NY 11710(516) 308-7070(516) 308-7071 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Eastbay Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTBAY MEDICAL PC (NPI 1063272474) is a healthcare organization registered as a dermatology in Bellmore, New York and active in the NPI registry since March 2024. The organization lists Jordan Fabrikant, Do, as its authorized official.

NPPES Registry Identity

NPI1063272474
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEASTBAY MEDICAL PC
Location Address2307 BELLMORE AVEBellmore, NY 11710-5651
Mailing Address2307 Bellmore AveBellmore, NY 11710-5651 · (513) 308-7070 · Fax (516) 308-7071
Phone(516) 308-7070
Fax(516) 308-7071
Organization SubpartNo
Authorized OfficialJordan FabrikantDo · (516) 308-7070
Enumeration DateMarch 21, 2024
NPPES CertifiedMarch 21, 2024
✔ NPI 1063272474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
2307 BELLMORE AVE, Bellmore, NY 11710
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eastbay Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Eastbay Medical PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Ashish Kumar, D.O.
Physical Medicine and Rehabilitation
NPI 1518302967
888 OLD COUNTRY RD
Plainview, NY 11803
(516) 229-1640
✔ PECOS7.7 mi
Jeffery Sklar, MD
Dermatology
NPI 1104898204
800 WOODBURY RD STE A
Woodbury, NY 11797
(516) 496-9400
✔ PECOS✔ Accepts Medicare9.7 mi
Robert Kraft, MD
Plastic and Reconstructive Surgery
NPI 1245238583
11203 QUEENS BLVD SUITE 205
Forest Hills, NY 11375
(718) 263-6868
✔ PECOS✔ Accepts Medicare17 mi
Kenneth Francis, MD
Dermatology
NPI 1326076464
114 E 71ST ST SUITE 1W
New York, NY 10021
(631) 878-4642
✔ PECOS24 mi
Jordan Fabrikant, D.O.
Dermatology
NPI 1649585753
921 TOWN CENTER DR
Orange City, FL 32763
(386) 218-1180
✔ PECOS✔ Accepts Medicare922 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastbay Medical PC's NPI number?

The NPI number for Eastbay Medical PC is 1063272474. It was assigned to this organization in the NPPES registry on March 21, 2024.

Where is Eastbay Medical PC located?

Eastbay Medical PC is located at 2307 Bellmore Ave, Bellmore, NY 11710. The listed phone number is (516) 308-7070.

What is Eastbay Medical PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Eastbay Medical PC enrolled in Medicare?

Yes. Eastbay Medical PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eastbay Medical PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Eastbay Medical PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (3), Physical Medicine and Rehabilitation (1) and Plastic and Reconstructive Surgery (1). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Eastbay Medical PC was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.