Individual provider Active NPI

Adam Eldahan, FNP DNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1023570520
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344492 Issued in NY
Practice address
1894 Walton Ave
Bronx, NY 10453-6018
Phone
(718) 583-3060
Fax
(718) 583-3360
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344492 NY Primary

Addresses

Primary practice location

1894 Walton Ave
Bronx, NY 10453-6018

Mailing address

1894 Walton Ave
Bronx, NY 10453-6018
Phone (718) 583-3060

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429000408 NY Order and Referring Only - Nurse Practitioner 7719211580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
344492NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: adam.eldahan.1@24989.direct.athenahealth.com
  • Direct secure messaging: adameldahan@mai.allscriptsdirect.net

Organizations & group practices 1

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1023570520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 WALTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536018",
            "telephone_number": "718-583-3060",
            "fax_number": "718-583-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 WALTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536018",
            "telephone_number": "718-583-3060",
            "fax_number": "718-583-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDAHAN",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "FNP DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.