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HENNESSEY DERMATOLOGY LLC
NPI 1790818623
Specialist in New York, NY

Active since March 13, 2007
161 MADISON AVE RM 6SE, NEW YORK, NY 10016(212) 677-5555(212) 677-5558 Get Directions Write a Review

NPPES record last updated: September 9, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 9, 2021, Feb 9, 2016 (2 updates tracked since 2016).

About Hennessey Dermatology Llc NPPES

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

HENNESSEY DERMATOLOGY LLC (NPI 1790818623) is a healthcare organization registered as a specialist in New York, New York and active in the NPI registry since March 2007. The organization lists N Patrick Hennessey, Physician, as its authorized official.

NPPES Registry Identity

NPI1790818623
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameHENNESSEY DERMATOLOGY LLC
Location Address161 MADISON AVE RM 6SENew York, NY 10016-5454
Mailing Address161 Madison Ave Rm 6seNew York, NY 10016-5454 · (212) 677-5555 · Fax (212) 677-5558
Phone(212) 677-5555
Fax(212) 677-5558
Organization SubpartNo
Authorized OfficialN Patrick HennesseyPhysician · (212) 677-5555
Enumeration DateMarch 13, 2007
Last NPPES UpdateSeptember 9, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2021
✔ NPI 1790818623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 133471
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.
161 MADISON AVE RM 6SE, New York, NY 10016
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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, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

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 IDO20070531000324Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
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 Hennessey Dermatology LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

N Patrick Hennessey, M.D.
Dermatology
NPI 1285694661
161 MADISON AVE RM 6SE
New York, NY 10016
(212) 677-5555
✔ 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 Hennessey Dermatology LLC's NPI number?

The NPI number for Hennessey Dermatology LLC is 1790818623. It was assigned to this organization in the NPPES registry on March 13, 2007.

Where is Hennessey Dermatology LLC located?

Hennessey Dermatology LLC is located at 161 Madison Ave Rm 6se, New York, NY 10016. The listed phone number is (212) 677-5555.

What is Hennessey Dermatology LLC's specialty?

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

Is Hennessey Dermatology LLC enrolled in Medicare?

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

When is Hennessey Dermatology LLC'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 January 31, 2027. 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 Hennessey Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Hennessey 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 Hennessey Dermatology LLC was last updated on September 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.