Individual provider Active NPI

Andzelika Dechnik

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • New York, NY
National Provider Identifier
1104452101
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
321447 Issued in NY
Practice address
622 W 168TH St # VC2-260
New York, NY 10032-3720
Phone
(617) 355-8241
NPI assigned
Mar 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 321447 NY Primary

Addresses

Primary practice location

622 W 168TH St # VC2-260
New York, NY 10032-3720

Mailing address

622 W 168TH St # VC2-260
New York, NY 10032-3720

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
I20260414001319 NY Practitioner - Pediatric Medicine 5092281485 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Hicksville Rd
Bethpage, NY 11714-3471

700 Hicksville Rd
Suite 205
Bethpage, NY 11714-3472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1104452101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST # VC2-260",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST # VC2-260",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "617-355-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECHNIK",
        "first_name": "ANDZELIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-21",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "321447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.