Individual provider Active NPI

Alexander P Edayadi, M.D.

  • Internal Medicine Physician
  • Merrick, NY
National Provider Identifier
1194738898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236727 Issued in NY
Practice address
1735 Carroll Ave
Merrick, NY 11566-2901
Phone
(516) 502-6699
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 236727 NY Primary

Addresses

Primary practice location

1735 Carroll Ave
Merrick, NY 11566-2901

Mailing address

1735 Carroll Ave
Merrick, NY 11566-2901
Phone (516) 502-6699

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
I20051010000536 NY Practitioner - Internal Medicine 0941225940 Practice locations: Merrick, NY

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194738898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 CARROLL AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115662901",
            "telephone_number": "516-502-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 CARROLL AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115662901",
            "telephone_number": "516-502-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDAYADI",
        "first_name": "ALEXANDER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.