Individual provider Active NPI

Freddy Nunez, PA-C

  • Medical Physician Assistant
  • Bay Shore, NY
National Provider Identifier
1467696658
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013116 Issued in NY
Practice address
8 Maple Ave
Bay Shore, NY 11706-8722
Phone
(631) 665-4392
NPI assigned
May 1, 2009
Last updated
May 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013116 NY Primary

Addresses

Primary practice location

8 Maple Ave
Bay Shore, NY 11706-8722

Mailing address

340 S 3Rd St Apt A2
Brooklyn, NY 11211-6347
Phone (347) 451-6727

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
I20180207002014 NY Order and Referring Only - Physician Assistant 2860752011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013116NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oda Primary Health Care Network, Inc. Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: freddy.nunez@oda.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1467696658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S 3RD ST APT A2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112116347",
            "telephone_number": "347-451-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MAPLE AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068722",
            "telephone_number": "631-665-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "FREDDY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.