Individual provider Active NPI

Andrew Jay Klein, M.D.

  • Pediatrics Physician
  • Fresh Meadows, NY
National Provider Identifier
1699859439
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
154039 Issued in NY
Practice address
7119 162ND St
Unit CFC
Fresh Meadows, NY 11365-4444
Phone
(718) 969-9700
Fax
(718) 969-7618
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 154039 NY Primary

Addresses

Primary practice location

7119 162ND St
Unit CFC
Fresh Meadows, NY 11365-4444

Mailing address

7119 162ND St
Unit CFC
Fresh Meadows, NY 11365-4444
Phone (718) 969-9700

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180706001909 NY Practitioner - Pediatric Medicine 2264788140 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154039NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Urgent Care, PLLC CurrentSince Jan 1, 2021 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
A. Klein M.D. Consulting, P.C. Past Accepting new patients

Locations

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Philadelphia, PA 19195

Organizations & group practices 4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1699859439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7119 162ND ST",
            "address_2": "UNIT CFC",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654444",
            "telephone_number": "718-969-9700",
            "fax_number": "718-969-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7119 162ND ST",
            "address_2": "UNIT CFC",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654444",
            "telephone_number": "718-969-9700",
            "fax_number": "718-969-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "ANDREW",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "154039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.