Individual provider Active NPI

Alexandra Fayne-Frederick, MD

  • Pediatric Adolescent Medicine Physician
  • New York, NY
National Provider Identifier
1326508318
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
315759 Issued in NY
Practice address
320 E 94TH St
New York, NY 10128-5604
Phone
(212) 423-3000
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 315759 NY
Pediatric Adolescent Medicine Physician 2080A0000X 315759 NY Primary

Addresses

Primary practice location

320 E 94TH St
New York, NY 10128-5604

Mailing address

320 E 94TH St
New York, NY 10128-5604
Phone (212) 423-3000

Other names 1

  • Alexandra Fayne-Frederick Other name

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
I20231204000374 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6507214467

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315759NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1326508318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E 94TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285604",
            "telephone_number": "212-423-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E 94TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285604",
            "telephone_number": "212-423-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYNE-FREDERICK",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "315759",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "315759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "FAYNE-FREDERICK",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.