57 WEST DERMATOLOGY LLC
NPI 1306224001
Dermatology in New York, NY

Active since May 13, 2015
57 W 57TH ST, SUITE 1109, NEW YORK, NY 10019(516) 297-2691 Get Directions Write a Review

NPPES record last updated: May 13, 2015. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About 57 West Dermatology Llc NPPES

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

57 WEST DERMATOLOGY LLC (NPI 1306224001) is a healthcare organization registered as a dermatology in New York, New York and active in the NPI registry since May 2015. The organization lists Alan Todd Glass, Owner, as its authorized official.

NPPES Registry Identity

NPI1306224001
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business Name57 WEST DERMATOLOGY LLC
Location Address57 W 57TH ST, SUITE 1109New York, NY 10019-2802
Mailing Address57 W 57th St, Suite 1109New York, NY 10019-2802 · (516) 297-2691
Organization SubpartNo
Authorized OfficialAlan Todd GlassOwner · (516) 297-2691
Enumeration DateMay 13, 2015
✔ NPI 1306224001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NY · 196509
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.
57 W 57TH ST, New York, NY 10019

Other Identifiers 2

Medicare UPING14795NY
Medicare UPINQ27626NY

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)

57 West Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to 57 West Dermatology LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1124015318
271 DOUGHTY BLVD
Inwood, NY 11096
(516) 239-4244
✔ PECOS✔ Accepts Medicare16 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 57 West Dermatology LLC's NPI number?

The NPI number for 57 West Dermatology LLC is 1306224001. It was assigned to this organization in the NPPES registry on May 13, 2015.

Where is 57 West Dermatology LLC located?

57 West Dermatology LLC is located at 57 W 57th St Suite 1109, New York, NY 10019. The listed phone number is (516) 297-2691.

What is 57 West Dermatology LLC's specialty?

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

Is 57 West Dermatology LLC enrolled in Medicare?

Yes. 57 West Dermatology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through 57 West Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to 57 West Dermatology LLC. 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 57 West Dermatology LLC was last updated on May 13, 2015. 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.