Individual provider Active NPI

Andrew Fagelman, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1407999378
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220049 Issued in NY
Practice address
155 Spring St
4TH Floor
New York, NY 10012-5208
Phone
(212) 343-0080
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220049 NY Primary

Addresses

Primary practice location

155 Spring St
4TH Floor
New York, NY 10012-5208

Mailing address

21 S End Ave Apt 440
New York, NY 10280-0019
Phone (212) 343-0080

Other identifiers 1

IdentifierTypeStateIssuer
02524183MedicaidNY

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
I20040510001393 NY Practitioner - Internal Medicine 4284623711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

155 Spring St
FL 4
New York, NY 10012-5208
Phone (212) 343-0080

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions40
Removal of nail tissue1-10
Skin biopsy12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Fagelman, MD, PLLC Internal Medicine CurrentSince Feb 9, 2014 Accepting new patients
Harlem Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

155 Spring St
Fl 4
New York, NY 10012
Phone (212) 226-1899

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

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.

Hospital & facility affiliations 8

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1407999378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 S END AVE APT 440",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102800019",
            "telephone_number": "212-343-0080",
            "fax_number": "212-343-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 SPRING ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100125208",
            "telephone_number": "212-343-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGELMAN",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02524183",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.