Individual provider Active NPI

Codi-Ann Dyer, NP

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1346611340
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382478-1 Issued in NY
Practice address
180 Fort Washington Ave
5TH Floor
New York, NY 10032-3722
Phone
(212) 342-3858
Fax
(212) 342-6865
NPI assigned
Oct 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F382478-1 NY Primary

Addresses

Primary practice location

180 Fort Washington Ave
5TH Floor
New York, NY 10032-3722

Mailing address

710 W 168TH St
7TH Floor, Room 738
New York, NY 10032-3726

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160107000896 NY Practitioner - Nurse Practitioner 6901108950 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F382478-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
New York University Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

710 W 168th St
New York, NY 10032
Phone (212) 305-0217

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

180 Fort Washington Ave
#11
New York, NY 10032

710 W 168th St
#1125A
New York, NY 10032
Phone (212) 342-4437

5 Columbus Cir
New York, NY 10019
Phone (212) 265-2828

51 W 51st St
Ste 360
New York, NY 10019
Phone (212) 326-8415

180 Fort Washington Ave
Fl 5
New York, NY 10032
Phone (212) 342-3858

710 W 168th St
Fl 7
New York, NY 10032
Phone (212) 305-1742

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: cod9025@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

NPI Registry JSON

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1346611340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "address_2": "7TH FLOOR, ROOM 738",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FORT WASHINGTON AVE",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323722",
            "telephone_number": "212-342-3858",
            "fax_number": "212-342-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "CODI-ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382478-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.