Individual provider Active NPI

Maria Fernando, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1093788580
Registry record updated Jul 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
154110 Issued in NY
Practice address
398 Himrod St
Brooklyn, NY 11237-4446
Phone
(718) 386-1111
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 154110 NY Primary

Addresses

Primary practice location

398 Himrod St
Brooklyn, NY 11237-4446

Mailing address

249 Virginia Ave
Fort Lee, NJ 07024-4323
Phone (201) 224-8098

Other identifiers 1

IdentifierTypeStateIssuer
00775517MedicaidNY

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
I20101207000329 NY Practitioner - Internal Medicine 3971790734

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154110NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Heights Medical Center Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mariafernando@whmc.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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279929600000",
    "number": "1093788580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 VIRGINIA AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244323",
            "telephone_number": "201-224-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 HIMROD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374446",
            "telephone_number": "718-386-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2010-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "154110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00775517",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.