Individual provider Active NPI

Andrea Nandini Persaud, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1013028687
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
230268 Issued in NY
Practice address
215 East 95TH Street
New York, NY 10128-4007
Phone
(212) 996-8000
Fax
(212) 423-3127
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 230268 NY Primary

Addresses

Primary practice location

215 East 95TH Street
New York, NY 10128-4007

Mailing address

55 Water St
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

1000 Church Ave
Brooklyn, NY 11218-2710
Phone (718) 826-4000

Other practice location 2

21 East 22nd Street
New York, NY 10010-9995
Phone (212) 460-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000421 NY Practitioner - Dermatology 7012956667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Icahn School of Medicine at Mount Sinai, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

220 Front St
New York, NY 10038-2033
Phone (212) 385-3700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
230268NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Derm Specs of PA PLLC Dermatology CurrentSince Mar 12, 2025 Accepting new patients
Out East Medical Dermatology PastSince Jun 15, 2021 Accepting new patients
Dac Physician Services,PC PastSince May 3, 2004 Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Atlas Infectious Disease Practice PLLC Past Accepting new patients

Locations

1027 46th Ave
Fl 1
Long Island City, NY 11101

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1013028687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 EAST 95TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284007",
            "telephone_number": "212-996-8000",
            "fax_number": "212-423-3127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Church Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112182710",
            "country_code": "US",
            "telephone_number": "718-826-4000",
            "fax_number": "718-826-4075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 East 22nd Street",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100109995",
            "country_code": "US",
            "telephone_number": "212-460-7800",
            "fax_number": "212-460-7877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "ANDREA",
        "middle_name": "NANDINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "230268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.