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MANHASSET DERMATOLOGY, P.C.
NPI 1205060662
Specialist in Manhasset, NY

Active since May 13, 2009
1165 NORTHERN BLVD, SUITE 405, MANHASSET, NY 11030(516) 365-8030(516) 365-8058 Get Directions Write a Review

NPPES record last updated: May 13, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Manhasset Dermatology, P.c. NPPES

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

MANHASSET DERMATOLOGY, P.C. (NPI 1205060662) is a healthcare organization registered as a specialist in Manhasset, New York and active in the NPI registry since May 2009. The organization lists John Steven Walczyk, President, as its authorized official.

NPPES Registry Identity

NPI1205060662
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMANHASSET DERMATOLOGY, P.C.
Location Address1165 NORTHERN BLVD, SUITE 405Manhasset, NY 11030-3048
Mailing Address1165 Northern Blvd, Suite 405Manhasset, NY 11030-3048 · (516) 365-8030 · Fax (516) 365-8058
Phone(516) 365-8030
Fax(516) 365-8058
Organization SubpartNo
Authorized OfficialJohn Steven WalczykPresident · (516) 365-8030
Enumeration DateMay 13, 2009
✔ NPI 1205060662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 191586
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1165 NORTHERN BLVD, Manhasset, NY 11030
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Manhasset Dermatology, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20090518000221Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Manhasset Dermatology, P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

John Walczyk, M.D.
Dermatology
NPI 1043233166
1165 NORTHERN BLVD SUITE 405
Manhasset, NY 11030
(516) 365-8030
✔ PECOS✔ Accepts MedicareSame address

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 Manhasset Dermatology, P.C.'s NPI number?

The NPI number for Manhasset Dermatology, P.C. is 1205060662. It was assigned to this organization in the NPPES registry on May 13, 2009.

Where is Manhasset Dermatology, P.C. located?

Manhasset Dermatology, P.C. is located at 1165 Northern Blvd Suite 405, Manhasset, NY 11030. The listed phone number is (516) 365-8030.

What is Manhasset Dermatology, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Manhasset Dermatology, P.C. enrolled in Medicare?

Yes. Manhasset Dermatology, P.C. is registered in the Medicare PECOS enrollment system.

When is Manhasset Dermatology, P.C.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Manhasset Dermatology, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Manhasset Dermatology, P.C.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Manhasset Dermatology, P.C. was last updated on May 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.