Individual provider Active NPI

Audrey Beth Berman-Davidowitz, MD

  • Pediatrics Physician
  • Bayside, NY
National Provider Identifier
1205912243
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
199599 Issued in NY
Practice address
2901 216TH St
St. Mary'S Hospital for Children
Bayside, NY 11360-2810
Phone
(718) 281-8977
Fax
(718) 281-8590
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 199599 NY Primary

Addresses

Primary practice location

2901 216TH St
St. Mary'S Hospital for Children
Bayside, NY 11360-2810

Mailing address

299 Maple St
West Hempstead, NY 11552-3203
Phone (516) 486-0454

Other identifiers 1

IdentifierTypeStateIssuer
199599OtherNYLICENSE

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
I20190729002593 NY Practitioner - Pediatric MedicinePractitioner - Hospice/Palliative Care 6204162274 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Marys Hospital for Children Inc. CurrentSince May 22, 2019 Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients
Flushing Emergency Practice Plan Past Accepting new patients

Locations

2901 216th St
Flushing, NY 11360
Phone (718) 281-8800

Organizations & group practices 3

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1205912243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 MAPLE ST",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523203",
            "telephone_number": "516-486-0454",
            "fax_number": "718-281-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 216TH ST",
            "address_2": "ST. MARY'S HOSPITAL FOR CHILDREN",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602810",
            "telephone_number": "718-281-8977",
            "fax_number": "718-281-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN-DAVIDOWITZ",
        "first_name": "AUDREY",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "199599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "199599",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.