Individual provider Active NPI

John Bernard Fiddler, N.P.

  • Adult Health Clinical Nurse Specialist
  • New York, NY
National Provider Identifier
1710154760
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
F304117-1 Issued in NY
Practice address
1770 Madison Ave FL 1
New York, NY 10035-4787
Phone
(212) 402-6107
Fax
(212) 824-2313
NPI assigned
May 9, 2008
Last updated
May 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X F304117-1 NY Primary

Addresses

Primary practice location

1770 Madison Ave FL 1
New York, NY 10035-4787

Mailing address

360 W 22ND St Apt 7P
New York, NY 10011-2630
Phone (646) 638-2809

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
I20170706000114 NY Practitioner - Nurse Practitioner 3274802392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F304117-1NYMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 2, 2025 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1710154760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W 22ND ST APT 7P",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112630",
            "telephone_number": "646-638-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 MADISON AVE FL 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354787",
            "telephone_number": "212-402-6107",
            "fax_number": "212-824-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDDLER",
        "first_name": "JOHN",
        "middle_name": "BERNARD",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NY",
            "license": "F304117-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.