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ADVANCED DERMATOLOGY ASSOCIATES
NPI 1508048240
Dermatology in Bronx, NY

Active since December 05, 2007
291 E 149TH ST, BRONX, NY 10451(718) 742-1000(212) 765-3210 Get Directions Write a Review

NPPES record last updated: December 10, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Advanced Dermatology Associates NPPES

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

ADVANCED DERMATOLOGY ASSOCIATES (NPI 1508048240) is a healthcare organization registered as a dermatology in Bronx, New York and active in the NPI registry since December 2007. The organization lists Lawrence D Jaeger, Officer, as its authorized official.

NPPES Registry Identity

NPI1508048240
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY OF NEW YORK PC
Location Address291 E 149TH STBronx, NY 10451-5601
Mailing Address200 Central Park S, Suite 107New York, NY 10019-1436 · (212) 262-2500 · Fax (212) 765-3210
Phone(718) 742-1000
Fax(212) 765-3210
Organization SubpartNo
Authorized OfficialLawrence D JaegerOfficer · (212) 262-2500
Enumeration DateDecember 5, 2007
Last NPPES UpdateDecember 10, 2014
✔ NPI 1508048240 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.
291 E 149TH ST, Bronx, NY 10451
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Other Names 1

Doing Business AsAdvanced Dermatology Associates

Other Identifiers 2

Other1508048240Npi
Medicare PINW37061

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)

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, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Kenneth Bloom, M.D.
Dermatology
NPI 1477536068
1455 WEST AVE
Bronx, NY 10462
(718) 239-1500
✔ PECOS✔ Accepts Medicare3.4 mi
James Icken, MD
Dermatology
NPI 1730156225
200 CENTRAL PARK S APT 107
New York, NY 10019
(212) 262-2500
✔ PECOS✔ Accepts Medicare4.6 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 Medicare58 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 Advanced Dermatology Of New York PC's NPI number?

The NPI number for Advanced Dermatology Of New York PC is 1508048240. It was assigned to this organization in the NPPES registry on December 5, 2007. 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 291 E 149th St, Bronx, NY 10451. The listed phone number is (718) 742-1000.

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, 2 practice 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 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.