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MONICA L. HALEM MD
NPI 1891996302
Dermatology in New York, NY

Active since May 30, 2007PECOS Enrolled
988 5TH AVE, NEW YORK, NY 10075(212) 988-2400 Get Directions Write a Review

NPPES record last updated: December 28, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Monica L. Halem Md NPPES

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

MONICA L. HALEM MD (NPI 1891996302) is an individual dermatology provider in New York, New York, licensed in New York (249120) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of University Of Miami, Lm Miller School Of Medicine (1997).

NPPES Registry Identity

NPI1891996302
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameMONICA L. HALEMCredential: MD
Location Address988 5TH AVENew York, NY 10075-0187
Mailing Address988 5th AveNew York, NY 10075-0187 · (212) 988-2400
Phone(212) 988-2400
Sole ProprietorYes
Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 1997
Enumeration DateMay 30, 2007
Last NPPES UpdateDecember 28, 2012
✔ NPI 1891996302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Licenses✔ Licensed in NY · 249120✔ Licensed in FL · ME98380
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.
988 5TH AVE, New York, NY 10075
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Monica L. Halem Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951491869
PECOS Enrollment IDI20080917000345
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Monica Halem reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Halem Dermatology PLLC
Same address
Dermatology
988 5TH AVE
New York, NY 10075
  • Reassigned Medicare billing, New York enrollment
NPI 1689334534 (212) 988-2400
Monica Halem MD PC
Same address
Dermatology
988 5TH AVE
New York, NY 10075
  • Reassigned Medicare billing, New York enrollment
  • 3 clinicians in this Medicare group
NPI 1740555309 (212) 988-2400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
231 services132 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
197 services137 patients
Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
178 services53 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
133 services106 patients
Biopsy of related skin growth, each additional growth 11103
A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.
116 services61 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
98 services77 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Biopsy Follow-Up
Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician
100%90 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
14%1,943 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%2,108 patients5/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
36%39 patients2/55-star benchmark: 98%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
95%1,803 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
95%1,803 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,803 patients1/55-star benchmark: 79%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
100%62 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HALEM DERMATOLOGY PLLC
Dermatology
988 5TH AVE
NEW YORK, NY 10075
New York County (212) 988-2400
JULIETTE ROSE CONDREN
Physician Assistant (Medical)
988 5TH AVE
NEW YORK, NY 10075
New York County (212) 988-2400
MONICA HALEM MD PC
Dermatology
988 5TH AVE
NEW YORK, NY 10075
New York County (212) 988-2400
HELEN HECHT MD PC
Family Medicine
988 5TH AVE
NEW YORK, NY 10075
New York County (212) 288-7300

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 Monica Halem's NPI number?

The NPI number for Monica Halem is 1891996302. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Where is Monica Halem located?

Monica Halem practices at 988 5th Ave, New York, NY 10075. The listed phone number is (212) 988-2400.

What is Monica Halem's specialty?

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

Is Monica Halem enrolled in Medicare?

Yes. Monica Halem is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Monica Halem's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Monica Halem reassigns Medicare benefits to 2 organizations: Halem Dermatology PLLC (New York, NY) and Monica Halem MD PC (New York, NY). Each 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 Monica Halem's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Monica Halem was last updated on December 28, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.