MICHAEL GLADSTEIN MD
NPI 1104848811
Dermatology in Lake Ronkonkoma, NY

Q: What is Michael Gladstein's NPI number?

The NPI number for Michael Gladstein is 1104848811. It was assigned to this individual provider in the NPPES registry on July 24, 2006.

Q: What is Michael Gladstein's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Michael Gladstein was last updated on December 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.

Active since July 24, 2006PECOS Enrolled

640 HAWKINS AVE, LAKE RONKONKOMA, NY 11779(631) 737-0100(631) 417-1117 Get Directions Write a Review

NPPES record last updated: December 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 10, 2025, Jun 22, 2018 (2 updates tracked since 2018).

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About Michael Gladstein Md NPPES

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

MICHAEL GLADSTEIN MD (NPI 1104848811) is an individual dermatology provider in Lake Ronkonkoma, New York, licensed in New York (143678) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Brooklyn, and is a graduate of New York University School Of Medicine (1979).

NPPES Registry Identity

NPI1104848811

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameMICHAEL GLADSTEINCredential: MD

Location Address640 HAWKINS AVELake Ronkonkoma, NY 11779-2324

Mailing Address2792 Ocean Ave Fl 2Brooklyn, NY 11229-4731 · (833) 635-2566 · Fax (833) 635-2566

Phone(631) 737-0100

Fax(631) 417-1117

Sole ProprietorNo

Medical School CMSNew York University School Of MedicineGraduated 1979

Enumeration DateJuly 24, 2006

Last NPPES UpdateDecember 10, 20252 updates tracked since enumeration

NPPES CertifiedDecember 10, 2025

✔ NPI 1104848811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in NY · 143678

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.

640 HAWKINS AVE, Lake Ronkonkoma, NY 11779

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Secondary Practice Location 1

Location 12792 Ocean Ave Fl 2Brooklyn, NY 11229-4731 · Phone (833) 635-2566 · Fax (833) 635-2565

Other Identifiers 1

Medicaid01850673NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Gladstein Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486637022

PECOS Enrollment IDI20040612000370

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Michael Gladstein reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Be Well Primary Health Care Center, LLC

46 mi

Multi-Specialty

3007 FARRAGUT ROAD
Brooklyn, NY 11210

Reassigned Medicare billing, New York enrollment
99 clinicians in this Medicare group

NPI 1083623409 (718) 434-0711

Ji Medical PC

47 mi

Clinic/Center

2792 OCEAN AVE FL 2
Brooklyn, NY 11229

Reassigned Medicare billing, New York enrollment
5 clinicians in this Medicare group

NPI 1366035248 (917) 855-0007

A Merryland Operating LLC

49 mi

Adolescent Medicine

2873 W 17TH ST FL 2
Brooklyn, NY 11224

Reassigned Medicare billing, New York enrollment
18 clinicians in this Medicare group

NPI 1972848307 (718) 265-0900

Jal 28 LLC

49 mi

Clinic/Center

2873 W 17TH ST
Brooklyn, NY 11224

Reassigned Medicare billing, New York enrollment
23 clinicians in this Medicare group

NPI 1063278281 (718) 265-0900

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

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

216 services116 patients

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

140 services20 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

68 services68 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

57 services35 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

53 services39 patients

Destruction of skin growth, 15 or more growths 17111

"Destruction of skin growth" refers to a procedure where unwanted skin growths, such as warts or moles, are removed. In this case, 15 or more growths are treated. Techniques may include freezing, burning, or laser therapy. It's a safe, quick process to improve skin health.

47 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11779 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%27 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TARA K SINGH MD

Internal Medicine