Active NPI
Ingrid Frydson Andrade
- Pediatric Critical Care Medicine Physician
- Atlanta, GA
National Provider Identifier
1013531235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 96036
- Practice address
- 2015 Uppergate Dr NE #516
Atlanta, GA 30322-0001 - Phone
- (404) 727-8997
- NPI assigned
- Jun 3, 2020
- Reactivated
- Apr 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Critical Care Medicine Physician | 2080P0203X | 96036 | GA | Primary |
Addresses
Primary practice location
2015 Uppergate Dr NE #516
Atlanta, GA 30322-0001
Mailing address
2015 Uppergate Dr NE #516
Atlanta, GA 30322-0001
Phone (404) 727-8997
Other practice location 1
333 N Santa Rosa St
Suite F3725
San Antonio, TX 78207
Phone (210) 704-3981
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013531235 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230721002251 | GA | Order and Referring Only - Pediatric Medicine | 1951761907 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1013531235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 UPPERGATE DR NE #516",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303220001",
"telephone_number": "404-727-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 UPPERGATE DR NE #516",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303220001",
"telephone_number": "404-727-8997"
}
],
"practiceLocations": [
{
"address_1": "333 N Santa Rosa St",
"address_2": "Suite F3725",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "78207",
"country_code": "US",
"telephone_number": "210-704-3981",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FRYDSON ANDRADE",
"first_name": "INGRID",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-03",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"deactivation_date": "2022-01-18",
"reactivation_date": "2022-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "GA",
"license": "96036",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013531235",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.