Individual provider Active NPI

Alix Dufresne, MD

  • Cardiovascular Disease Physician
  • Brooklyn, NY
National Provider Identifier
1700819950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
157033 Issued in NY
Practice address
1166 Eastern Pkwy
Brooklyn, NY 11213-4108
Phone
(718) 771-4987
Fax
(718) 771-6001
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 157033 NY Primary

Addresses

Primary practice location

1166 Eastern Pkwy
Brooklyn, NY 11213-4108

Mailing address

1166 Eastern Pkwy
Brooklyn, NY 11213-4108
Phone (718) 771-4987

Other identifiers 1

IdentifierTypeStateIssuer
00859485MedicaidNY

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
I20110526000761 NY Practitioner - Cardiovascular Disease (Cardiology) 0840477949 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157033NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Emergency Medicine, P.C. Current Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Jan 1, 2012 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jan 11, 2022 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Jan 11, 2022 Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1166 Eastern Pkwy
Brooklyn, NY 11213
Phone (718) 771-4987

1110 Eastern Pkwy
Pier Toussaint
Brooklyn, NY 11213
Phone (718) 735-1900

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700819950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134108",
            "telephone_number": "718-771-4987",
            "fax_number": "718-771-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134108",
            "telephone_number": "718-771-4987",
            "fax_number": "718-771-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFRESNE",
        "first_name": "ALIX",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "157033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00859485",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.