Individual provider Active NPI

Jeffrey A Naiditch, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1437243789
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
133154 Issued in NY
Practice address
30 5TH Ave
Suite1B
New York, NY 10011-8803
Phone
(212) 228-5548
Fax
(212) 228-8780
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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 133154 NY Primary

Addresses

Primary practice location

30 5TH Ave
Suite1B
New York, NY 10011-8803

Mailing address

30 5TH Ave Apt 1B
New York, NY 10011-8803
Phone (212) 228-5548

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
I20110111000810 NY Practitioner - Internal Medicine 9335338011 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Pennsylvania, 1980
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 5TH Ave
Apt 1B
New York, NY 10011-8803
Phone (212) 228-5548

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
133154NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1437243789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 5TH AVE APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118803",
            "telephone_number": "212-228-5548",
            "fax_number": "212-228-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 5TH AVE",
            "address_2": "SUITE1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118803",
            "telephone_number": "212-228-5548",
            "fax_number": "212-228-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDITCH",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "133154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.