Primary Care Physician Specialist

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIMARY CARE PHYSICIAN SPECIALIST

Practice address

1927 Williamsbridge Rd
Bronx, NY 10461-1604

Phone

(718) 828-1549

Fax

(718) 828-5029

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Andrea Elba Andrade, MD

Title

President

Phone

(914) 498-3635

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1205671583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611604",
            "telephone_number": "718-828-1549",
            "fax_number": "718-828-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611604",
            "telephone_number": "718-828-1549",
            "fax_number": "718-828-5029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1261 Thieriot Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104724713",
            "country_code": "US",
            "telephone_number": "718-828-1549",
            "fax_number": "718-828-5029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMARY CARE PHYSICIAN SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "ANDRADE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "ELBA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-498-3635",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04938047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.