Individual provider Active NPI

Amrita Persaud, D.D.S

  • General Practice Dentistry
  • Queens Village, NY
National Provider Identifier
1568796746
Registry record updated Jun 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054650 Issued in NY
Practice address
8034 222ND St
Queens Village, NY 11427
Phone
(917) 862-1509
NPI assigned
Sep 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 054650 NY Primary

Addresses

Primary practice location

8034 222ND St
Queens Village, NY 11427

Mailing address

8034 222ND St
Queens Village, NY 11427-1221
Phone (917) 862-1509

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180813000488 NY Practitioner - Dentist 7315295045 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Jul 1, 2018 Accepting new patients
Bronxcare Health System CurrentSince Jul 1, 2018 Accepting new patients
Union Community Health Center, Inc. CurrentSince Sep 20, 2023 Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

Interoperability endpoints

  • Direct secure messaging: amrita.persaud.1@18107.direct.athenahealth.com

Organizations & group practices 3

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527897600000",
    "number": "1568796746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8034 222ND ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271221",
            "telephone_number": "917-862-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8034 222ND ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11427",
            "telephone_number": "917-862-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "AMRITA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2018-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.