Andrew James Fidurko, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095297 Issued in NY

Practice address

29 E Cayuga St
Oswego, NY 13126-1241

Phone

(315) 326-4100

NPI assigned

Nov 26, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brave Medical PCGroup PAC ID 2567882731, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brave Medical P.C.

  • Community/Behavioral Health Agency
  • Yonkers, NY
  • NPI 1902415318
  Medicare reassignment Care Compare group NPD
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Medicare reassignment NPD
• Oswego Hospital

  • Institutional Pharmacy
  • Oswego, NY
  • NPI 1780629907
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1003452939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E CAYUGA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261241",
            "telephone_number": "315-326-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDURKO",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "081157",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Angelica Matahum Farrell, DPT
• Bryanna Nicole Fazio, PT, DPT, CSCS
• Rebecca L Fedor
• Lyndsey Nicole Fellows, MA, SLP
• Michelle Renee Fellows, LPN
• Richard Lawrence Fiese, DMD
• Alexander William Filipski, DO
• Chonna Jihanna Finch, NP
• Michelle Lynn Finlon, MT
• Emily Finn, OTR/L

• Clinical Social Worker in Oswego, NY
• Providers in Oswego, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.