Individual provider Active NPI

Adrienne Fleckman, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
National Provider Identifier
1033174263
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
124620 Issued in NY
Practice address
350 E 17TH St
New York, NY 10003-3805
Phone
(212) 420-4481
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 124620 NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 124620 NY Primary

Addresses

Primary practice location

350 E 17TH St
New York, NY 10003-3805

Mailing address

350 E 17TH St
New York, NY 10003-3805
Phone (212) 420-4481

Other identifiers 1

IdentifierTypeStateIssuer
01010342MedicaidNY

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
I20040821000200 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 6103890660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124620NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bimc Faculty Practice Past Accepting new patients
Beth Israel Medical Center Internal Medicine Past Accepting new patients

Organizations & group practices 2

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1033174263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033805",
            "telephone_number": "212-420-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033805",
            "telephone_number": "212-420-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECKMAN",
        "first_name": "ADRIENNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "124620",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "124620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01010342",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.