Individual provider Active NPI

Alexander V. Baldonado, M.D.

  • Family Medicine Physician
  • Woodside, NY
National Provider Identifier
1508874819
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
271367 Issued in NY
Practice address
6317 Roosevelt Ave
Woodside, NY 11377-3641
Phone
(347) 825-8288
NPI assigned
Aug 3, 2006
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 271367 NY Primary

Addresses

Primary practice location

6317 Roosevelt Ave
Woodside, NY 11377-3641

Mailing address

PO Box 778249
Woodside, NY 11377-8249

Other practice location 1

14821 Jamaica Ave
Jamaica, NY 11435-4032
Phone (929) 296-7130

Other practice location 2

2320 Avenue U
Brooklyn, NY 11229
Phone (347) 492-4695

Other practice location 3

5718 Woodside Ave Fl 2
Woodside, NY 11377-3415
Phone (347) 825-8288

Other identifiers 1

IdentifierTypeStateIssuer
02061425MedicaidNY

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
I20070509000704 NY Practitioner - Family PracticePractitioner - Emergency Medicine 0143326025 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002901NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Sep 16, 2018 Accepting new patients
The Parkway Hospital Past Accepting new patients
Ny Acute Care Specialists PC Past Accepting new patients
Doctor Medical of Ny PC Family Medicine Past Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

Organizations & group practices 5

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1508874819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778249",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113778249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6317 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773641",
            "telephone_number": "347-825-8288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14821 Jamaica Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114354032",
            "country_code": "US",
            "telephone_number": "929-296-7130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2320 Avenue U",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11229",
            "country_code": "US",
            "telephone_number": "347-492-4695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5718 Woodside Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Woodside",
            "state": "NY",
            "postal_code": "113773415",
            "country_code": "US",
            "telephone_number": "347-825-8288",
            "fax_number": "347-730-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDONADO",
        "first_name": "ALEXANDER",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "271367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02061425",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.