Active NPI
Byron Legardye, CPRA
- Specialist
- Bronx, NY
National Provider Identifier
1639927866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- CPRA6163
- Practice address
- 1169 River Ave Apt 801
Bronx, NY 10452-8494 - Phone
- (718) 964-8613
- NPI assigned
- May 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | CPRA6163 | NY | Primary |
Addresses
Primary practice location
1169 River Ave Apt 801
Bronx, NY 10452-8494
Mailing address
1169 River Ave Apt 801
Bronx, NY 10452-8494
Phone (718) 964-8613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPRA6163 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CPRA6163 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1639927866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1169 RIVER AVE APT 801",
"city": "BRONX",
"state": "NY",
"postal_code": "104528494",
"telephone_number": "718-964-8613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1169 RIVER AVE APT 801",
"city": "BRONX",
"state": "NY",
"postal_code": "104528494",
"telephone_number": "718-964-8613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGARDYE",
"first_name": "BYRON",
"credential": "CPRA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "CPRA6163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CPRA6163",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.