Individual provider Active NPI

Andrea Feghali, NP

  • Adult Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1124570528
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307901-1 Issued in NY
Practice address
3400 Bainbridge Ave
3Rd Floor
Bronx, NY 10467-2404
Phone
(718) 920-2991
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307901-1 NY Primary

Addresses

Primary practice location

3400 Bainbridge Ave
3Rd Floor
Bronx, NY 10467-2404

Mailing address

340 E 64TH St
#5G
New York, NY 10065-7503
Phone (914) 275-7170

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
I20170331000954 NY Practitioner - Nurse Practitioner 5597040600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

380 2ND Ave
New York, NY 10010-5615
Phone (212) 614-8379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F307901-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 7, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 7, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

380 2nd Ave
Fl 9
New York, NY 10010
Phone (212) 614-8379

380 2nd Ave
New York, NY 10010
Phone (212) 253-6600

10 Union Sq E
Ste 4F
New York, NY 10003
Phone (212) 844-8020

Organizations & group practices 4

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": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1124570528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 E 64TH ST",
            "address_2": "#5G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657503",
            "telephone_number": "914-275-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "address_2": "3RD FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEGHALI",
        "first_name": "ANDREA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307901-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.