Individual provider Active NPI

Carlyn Ann Oppedisano, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1073512604
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
153200 Issued in NY
Practice address
2600 Netherland Ave
Suite 120
Bronx, NY 10463-4801
Phone
(718) 796-3580
Fax
(718) 796-3987
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 153200 NY Primary

Addresses

Primary practice location

2600 Netherland Ave
Suite 120
Bronx, NY 10463-4801

Mailing address

2600 Netherland Ave
Suite 120
Bronx, NY 10463-4801
Phone (718) 796-3580

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
I20221017000957 NY Practitioner - Pediatric Medicine 4284000282 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153200NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Oct 1, 2022 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Oct 1, 2022 Accepting new patients
Riverdale Pediatrics, P.C. Past Accepting new patients

Locations

2600 Netherland Ave
Ste 120
Bronx, NY 10463
Phone (718) 796-3580

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

40 Sunshine Cottage Rd
Ofc 1ND
Valhalla, NY 10595

100 Woods Rd
#O
Valhalla, NY 10595

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: carlyn.oppedisano.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 3

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073512604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 NETHERLAND AVE",
            "address_2": "SUITE 120",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634801",
            "telephone_number": "718-796-3580",
            "fax_number": "718-796-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NETHERLAND AVE",
            "address_2": "SUITE 120",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634801",
            "telephone_number": "718-796-3580",
            "fax_number": "718-796-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPEDISANO",
        "first_name": "CARLYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "153200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.