Individual provider Active NPI

Amanda Nicole Kravitz, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1366079741
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
322559 Issued in NY
Practice address
2315 Broadway
New York, NY 10024-4332
Phone
(646) 962-2110
Fax
(646) 962-0160
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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 322559 NY Primary

Addresses

Primary practice location

2315 Broadway
New York, NY 10024-4332

Mailing address

2315 Broadway
New York, NY 10024-4332
Phone (469) 622-1106

Other practice location 1

12 W 72nd St
New York, NY 10023-4163
Phone (646) 962-7800

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address amk9090@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
322559NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell University Medical College Past Accepting new patients

Organizations & group practices 1

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1366079741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244332",
            "telephone_number": "469-622-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244332",
            "telephone_number": "646-962-2110",
            "fax_number": "646-962-0160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 W 72nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100234163",
            "country_code": "US",
            "telephone_number": "646-962-7800",
            "fax_number": "646-962-0415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAVITZ",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "322559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2315 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100244332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "2315 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100244332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amk9090@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "2315 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100244332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.