Andrea Faulkner, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

182742 Issued in NY

Practice address

10 Office Park Way
Pittsford, NY 14534-1765

Phone

(585) 586-9640

Fax

(585) 586-5512

NPI assigned

Dec 4, 2006

Last updated

Sep 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ontario County

  • Social Worker
  • Canandaigua, NY
  • NPI 1003802190
  Medicare reassignment
• Nysarc Inc

  dba Monroe County Chapter

  • Developmental Disabilities Clinic/Center
  • Rochester, NY
  • NPI 1457458424
  NPD (past)
• Rochester Rehabilitation Center, Inc

  • Community/Behavioral Health Agency
  • Rochester, NY
  • NPI 1306901913
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1649348897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 LIME ROCK LN",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146103122",
            "telephone_number": "585-381-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OFFICE PARK WAY",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341765",
            "telephone_number": "585-586-9640",
            "fax_number": "585-586-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "ANDREA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "182742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01482686",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fantuzzo Oral, Maxillofacial, and Dental Implant Surgery, PLLC
• Rachel Leah Farkas, M.D.
• Evan Schweigert Farley, LCSW
• Yoko Farmer, LCSW
• Vincent Joseph Fasanello, MD
• Marti Clement Fausold-Mowers, ED.D., MSW, LCSW
• Michael Shane Fauth, FNP
• Fe B Whitcomb
• Tamar Feldman, L.AC.
• Deborah Ann Fenton, LMT

• Child & Adolescent Psychiatry Physician in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.