Individual provider Active NPI

James Marc Friedman, ANP

  • Primary Care Nurse Practitioner
  • Floral Park, NY
National Provider Identifier
1508935875
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F303060 Issued in NY
Practice address
166 Mayfair Ave
Floral Park, NY 11001-2350
Phone
(516) 488-4017
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1016 AK
Primary Care Nurse Practitioner 363LP2300X F303060 NY Primary

Addresses

Primary practice location

166 Mayfair Ave
Floral Park, NY 11001-2350

Mailing address

166 Mayfair Ave
Floral Park, NY 11001-2350
Phone (516) 488-4017

Other identifiers 2

IdentifierTypeStateIssuer
NP0052MedicaidAK
00246075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1016AKMDAdult Health Nurse Practitioner
F303060NYMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1508935875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MAYFAIR AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012350",
            "telephone_number": "516-488-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MAYFAIR AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012350",
            "telephone_number": "516-488-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "JAMES",
        "middle_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AK",
            "license": "1016",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F303060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0052",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.