Individual provider Active NPI

Edrist Duneant, M.D.

  • Emergency Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1205575016
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
339218 Issued in NY
Practice address
327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone
(718) 869-7000
NPI assigned
May 31, 2022
Reactivated
Aug 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 339218 NY Primary

Addresses

Primary practice location

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Mailing address

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000

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
I20251027002777 NY Practitioner - Emergency Medicine 4486143963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4535 Dressler Rd NW
Canton, MA 44718-2545

90 Bay St LNDG
Apt 5M
Staten Island, NY 10301-2663

Hospital & facility affiliations

  • St John'S Episcopal Hospital at South Shore Hospital, Far Rockaway, NY, CCN 330395

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339218NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Island Emergency Medical Services, P.C. Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients

Locations

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1205575016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNEANT",
        "first_name": "EDRIST",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "deactivation_date": "2023-02-27",
        "reactivation_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "339218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.