Individual provider Active NPI

Andrew V Doodnauth, DO

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1639630569
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1639630569 Issued in NY
Practice address
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone
(718) 270-4220
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 1639630569 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203-2012

Mailing address

55 W Dover St
Valley Stream, NY 11580-4128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260307000177 NY Practitioner - Internal Medicine 6901388974 Reassigns benefits to 1 organization
I20260406000664 WI Practitioner - Internal Medicine 6901388974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1639630569NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC CurrentSince Feb 1, 2026 Accepting new patients

Organizations & group practices 2

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1639630569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W DOVER ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOODNAUTH",
        "first_name": "ANDREW",
        "middle_name": "V",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1639630569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.