1. Home
  2. Directory
  3. New York
  4. New York New York
  5. Dermatology
  6. NPI Profile

ADVANCED DERMATOLOGY ASSOCIATES
NPI 1083610521
Dermatology in New York, NY

Active since June 21, 2005CLIA 33D2194979 · Certificate of Compliance
200 CENTRAL PARK S, STE 107, NEW YORK, NY 10019(212) 262-2500(212) 246-0890 Get Directions Write a Review

NPPES record last updated: December 10, 2014. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Advanced Dermatology Associates NPPES

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

ADVANCED DERMATOLOGY ASSOCIATES (NPI 1083610521) is a healthcare organization registered as a dermatology in New York, New York and active in the NPI registry since June 2005. The organization holds a CLIA Certificate of Compliance certificate valid through December 4, 2027 and lists Lawrence D Jaeger, Officer, as its authorized official.

NPPES Registry Identity

NPI1083610521
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY OF NEW YORK PC
Location Address200 CENTRAL PARK S, STE 107New York, NY 10019-1449
Mailing Address200 Central Park S, Ste 107New York, NY 10019-1449 · (212) 262-2500 · Fax (212) 246-0890
Phone(212) 262-2500
Fax(212) 246-0890
Organization SubpartNo
Authorized OfficialLawrence D JaegerOfficer · (212) 262-2500
Enumeration DateJune 21, 2005
Last NPPES UpdateDecember 10, 2014
✔ NPI 1083610521 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.
200 CENTRAL PARK S, New York, NY 10019
Open in Google Maps ↗

Other Names 1

Doing Business AsAdvanced Dermatology Associates

Other Identifiers 2

Medicare PINW37061NY
Other108361052Npi

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Dermatology Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Advanced Dermatology Associates, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

James Icken, MD
Dermatology
NPI 1730156225
200 CENTRAL PARK S APT 107
New York, NY 10019
(212) 262-2500
✔ PECOS✔ Accepts MedicareSame address
Kenneth Bloom, M.D.
Dermatology
NPI 1477536068
1455 WEST AVE
Bronx, NY 10462
(718) 239-1500
✔ PECOS✔ Accepts Medicare7.8 mi
Marc Handler, M.D.
Micrographic Dermatologic Surgery (MDS)
NPI 1376854836
1700 WHITEHORSE HAMILTON SQUARE RD STE D1
Hamilton, NJ 08690
(609) 890-2600
✔ PECOS✔ Accepts Medicare53 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D2194979

Advanced Dermatology PC · New York, NY
Active · expires Dec 4, 2027
CLIA Number33D2194979
Laboratory TypePhysician Office
Certificate Effective DateDecember 5, 2025
Certificate Expiration DateDecember 4, 2027
Laboratory DirectorDr. Aton M. Holzer
Laboratory Phone(212) 262-2500
Laboratory LocationAdvanced Dermatology PC200 Central Park South Suite #107, New York, NY 10019
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Advanced Dermatology Of New York PC's NPI number?

The NPI number for Advanced Dermatology Of New York PC is 1083610521. It was assigned to this organization in the NPPES registry on June 21, 2005. The provider is doing business as Advanced Dermatology Associates.

Where is Advanced Dermatology Of New York PC located?

Advanced Dermatology Of New York PC is located at 200 Central Park S Ste 107, New York, NY 10019. The listed phone number is (212) 262-2500.

What is Advanced Dermatology Of New York PC's specialty?

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

Is Advanced Dermatology Of New York PC enrolled in Medicare?

Yes. Advanced Dermatology Of New York PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Dermatology Of New York PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Advanced Dermatology Of New York PC, in Dermatology and Micrographic Dermatologic Surgery (MDS). 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advanced Dermatology Of New York PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 33D2194979) is associated with this NPI, valid through December 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Advanced Dermatology Of New York PC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Advanced Dermatology Of New York PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Advanced Dermatology Of New York PC was last updated on December 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.