Active NPI
Angela B Kedzior, MD
- Pediatrics Physician
- Bronx, NY
National Provider Identifier
1336272616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 199278
- Practice address
- South Bronx Health Center
871 Prospect Avenue
Bronx, NY 10459 - Phone
- (718) 991-0605
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 199278 | NY | Primary |
Addresses
Primary practice location
South Bronx Health Center
871 Prospect Avenue
Bronx, NY 10459
Mailing address
31 Cliff Street
Hastings on Hudson, NY 10706
Phone (914) 591-6039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 18, 2016 through Apr 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Past | Accepting new patients | |
| Putnam Family and Community Services Inc | Past | Accepting new patients | |
| Montefiore Medical Center | Pediatrics | Past | Accepting new patients |
| Putnam Family and Community Services Inc | Past | Accepting new patients |
Organizations & group practices 4
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.
-
dba Montefiore Community Pharmacy @ CHAM
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
dba CoveCare Center
- Mental Health Counselor
- Carmel, NY
- NPI 1497737167
-
dba CoveCare Center
- Mental Illness Community Based Residential Treatment Facility
- Carmel, NY
- NPI 1972458545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336272616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 CLIFF STREET",
"city": "HASTINGS ON HUDSON",
"state": "NY",
"postal_code": "10706",
"telephone_number": "914-591-6039",
"fax_number": "718-991-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SOUTH BRONX HEALTH CENTER",
"address_2": "871 PROSPECT AVENUE",
"city": "BRONX",
"state": "NY",
"postal_code": "10459",
"telephone_number": "718-991-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEDZIOR",
"first_name": "ANGELA",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "199278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.