Individual provider Active NPI

Amy Bandriwsky

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1104437052
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025721 Issued in NY
Practice address
4422 3Rd Ave
Bronx, NY 10457-2545
Phone
(718) 960-9000
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025721 NY Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2545

Mailing address

62 Gordon St
Yonkers, NY 10701-5812
Phone (914) 320-2878

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N.A ST. BARNABAS HOSPITAL

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
I20210107000152 NY Practitioner - Physician Assistant 6002229267 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025721NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Physician Assistant CurrentSince Mar 10, 2021 Accepting new patients
Bronxcare Health System CurrentSince Mar 10, 2021 Accepting new patients

Locations

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1104437052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 GORDON ST",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107015812",
            "telephone_number": "914-320-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDRIWSKY",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025721",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N.A",
            "affiliation": "Y",
            "affiliationName": "ST. BARNABAS HOSPITAL",
            "address_1": "4422 3rd Ave",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104572545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.