Individual provider Active NPI

Kathleen A Andre, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1710152053
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
334319 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6500
Phone
(212) 241-8095
Fax
(212) 987-1323
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 334319 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6500

Mailing address

1024 E 218TH St
Bronx, NY 10469-1211
Phone (212) 241-8095

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140205001170 NY Order and Referring Only - Nurse Practitioner 3678702065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
334319NYMDMaternal & Fetal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1710152053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 E 218TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104691211",
            "telephone_number": "212-241-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-8095",
            "fax_number": "212-987-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "334319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.