ADVANCED DERMATOLOGY OF NEW YORK, P.C.
NPI 1497017552
Specialist in Bronx, NY
About Advanced Dermatology Of New York, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADVANCED DERMATOLOGY OF NEW YORK, P.C. (NPI 1497017552) is a healthcare organization registered as a specialist in Bronx, New York and active in the NPI registry since June 2012. The organization lists Lawrence D Jaeger, Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 Of New York, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Advanced Dermatology Of New York, P.C., 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)
Hamilton, NJ 08690
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 Advanced Dermatology Of New York, P.C.'s NPI number?
The NPI number for Advanced Dermatology Of New York, P.C. is 1497017552. It was assigned to this organization in the NPPES registry on June 13, 2012.
Where is Advanced Dermatology Of New York, P.C. located?
Advanced Dermatology Of New York, P.C. is located at 1455 West Ave, Bronx, NY 10462. The listed phone number is (212) 262-2500.
What is Advanced Dermatology Of New York, P.C.'s specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Advanced Dermatology Of New York, P.C. enrolled in Medicare?
Yes. Advanced Dermatology Of New York, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Advanced Dermatology Of New York, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Advanced Dermatology Of New York, P.C., 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.
When was this NPI record last updated?
The NPPES record for Advanced Dermatology Of New York, P.C. was last updated on December 8, 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.
# Advanced Dermatology Of New York, P.c. · NPI 1497017552
Specialist organization in Bronx, New York. Organization record, active in the CMS NPPES registry since June 13, 2012.
## Identity
- **NPI:** 1497017552 (Entity type: Organization)
- **Enumerated:** June 13, 2012
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Lawrence Jaeger, OFFICER
## Practice location
- **Address:** 1455 WEST AVE, Bronx, NY 10462-7304
- **Phone:** (212) 262-2500 · **Fax:** (212) 765-3210
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (2), Micrographic Dermatologic Surgery (MDS) (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 8, 2014
---
Source: [NPI Profile](https://npiprofile.com/npi/1497017552) · Data from the CMS NPPES public registry.