Individual provider Active NPI

Andrew Roy Williams, MD

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1407120645
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
273465 Issued in NY
Practice address
1400 Pelham Pkwy South. Building 6 Suite 1B25
Jacobi Medical Center Emergency Dept.
Bronx, NY 10461-1138
Phone
(718) 918-5820
NPI assigned
Mar 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 273465 NY Primary

Addresses

Primary practice location

1400 Pelham Pkwy South. Building 6 Suite 1B25
Jacobi Medical Center Emergency Dept.
Bronx, NY 10461-1138

Mailing address

1400 Pelham Pkwy South. Building 6 Suite 1B25
Jacobi Medical Center Emergency Dept.
Bronx, NY 10461-1138

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
I20150213000897 NY Practitioner - Emergency Medicine 2365767308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273465NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current Accepting new patients
Montefiore Medical Center Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2015 Accepting new patients
Fpa Hospital Based CurrentSince Mar 1, 2020 Accepting new patients
Jacobi Medical Center Ed Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1407120645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY SOUTH. BUILDING 6 SUITE 1B25",
            "address_2": "JACOBI MEDICAL CENTER EMERGENCY DEPT.",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY SOUTH. BUILDING 6 SUITE 1B25",
            "address_2": "JACOBI MEDICAL CENTER EMERGENCY DEPT.",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREW",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-06",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "273465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.