Individual provider Active NPI

Fabiola Alouidor, NP

  • Adult Health Nurse Practitioner
  • Bay Shore, NY
National Provider Identifier
1427627595
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310374 Issued in NY
Practice address
1745 Union Blvd
Bay Shore, NY 11706-7952
Phone
(631) 328-5560
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 722988 NY
Adult Health Nurse Practitioner 363LA2200X 310374 NY Primary

Addresses

Primary practice location

1745 Union Blvd
Bay Shore, NY 11706-7952

Mailing address

1603 Baldwin Blvd
Bay Shore, NY 11706-2145
Phone (914) 483-7322

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
I20230223002114 NY Practitioner - Nurse Practitioner 6002285467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medical Care of Bayshore, PCGroup PAC ID 8921143751, 3 clinicians

Practice addresses (Care Compare)

1745 Union Blvd
Bay Shore, NY 11706-7952
Phone (631) 328-5560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
722988NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Care of Bayshore, PC CurrentSince Oct 22, 2022 Accepting new patients
Long Island Osteoporosis & Arthritis Center Current Accepting new patients

Locations

1745 Union Blvd
Bay Shore, NY 11706
Phone (631) 328-5560

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20167/brand/1/csg/1/fhir/r4
  • Direct secure messaging: fabiola.alouidor.1@20167.direct.athenahealth.com

Organizations & group practices 2

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1427627595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 BALDWIN BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062145",
            "telephone_number": "914-483-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067952",
            "telephone_number": "631-328-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALOUIDOR",
        "first_name": "FABIOLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "722988",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.