Alexis Etheridge, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

342553 Issued in NY

Practice address

550 1St Ave
New York, NY 10016-6402

Phone

(212) 263-5506

NPI assigned

Apr 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Pediatric Medicine

Education

Rutgers, Robert Woood Johnson Medical School, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: aetheridge558299@nyumc.direct-ci.com

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1326735317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "ALEXIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "342553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azim Etemadi, M.D.
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• Alexis Etheridge
• Michael A Etheridge, LMSW
• Ethical Drug Inc
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• Ethnik Nutrition Practice LLC
• Oghenefejiro M Etibo

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.