BODIAN DERMATOLOGY GROUP, P.C
NPI 1659412104
Specialist in Great Neck, NY
About Bodian Dermatology Group, P.c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BODIAN DERMATOLOGY GROUP, P.C (NPI 1659412104) is a healthcare organization registered as a specialist in Great Neck, New York and active in the NPI registry since February 2007. The organization holds a CLIA Certificate of Compliance certificate valid through October 12, 2027 and lists Adam Ben Bodian, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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)
Bodian Dermatology Group, P.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Bodian Dermatology Group, P.C, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Great Neck, NY 11021
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 33D0678450
Bodian Dermatology Group PC · Great Neck, NYFrequently 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 Bodian Dermatology Group, P.C's NPI number?
The NPI number for Bodian Dermatology Group, P.C is 1659412104. It was assigned to this organization in the NPPES registry on February 9, 2007.
Where is Bodian Dermatology Group, P.C located?
Bodian Dermatology Group, P.C is located at 11 Grace Ave Suite 100, Great Neck, NY 11021. The listed phone number is (516) 482-2882.
What is Bodian Dermatology Group, P.C's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Bodian Dermatology Group, P.C enrolled in Medicare?
Yes. Bodian Dermatology Group, P.C is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bodian Dermatology Group, P.C?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Bodian Dermatology Group, 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. The largest specialties are Dermatology (3), Pathology (2) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bodian Dermatology Group, P.C hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 33D0678450) is associated with this NPI, valid through October 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Bodian Dermatology Group, P.C was last updated on May 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Bodian Dermatology Group, P.c · NPI 1659412104
Specialist organization in Great Neck, New York. Organization record, active in the CMS NPPES registry since February 9, 2007.
## Identity
- **NPI:** 1659412104 (Entity type: Organization)
- **Enumerated:** February 9, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Adam Bodian, PRESIDENT
## Practice location
- **Address:** 11 GRACE AVE, SUITE 100, Great Neck, NY 11021-2417
- **Phone:** (516) 482-2882 · **Fax:** (516) 482-6039
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (3), Pathology (2), Micrographic Dermatologic Surgery (MDS) (1); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 29, 2008
- **Other identifiers:** Other CN7593 (NY); Medicare ID-Type Unspecified WEN681 (NY)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1659412104) · Data from the CMS NPPES public registry.