Individual provider Active NPI

Albert Edano Edano, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1720146699
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
198162-1 Issued in NY
Practice address
1963 Rockaway Pkwy
Brooklyn, NY 11236-5505
Phone
(718) 241-1513
Fax
(718) 241-1513
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 198162-1 NY Primary

Addresses

Primary practice location

1963 Rockaway Pkwy
Brooklyn, NY 11236-5505

Mailing address

741 Turf Rd
Valley Stream, NY 11581-3505
Phone (516) 792-0789

Other identifiers 1

IdentifierTypeStateIssuer
01591400MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198162-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albert E Edano MD PC Internal Medicine Past Accepting new patients
Medical Network Services PC Internal Medicine Past Accepting new patients
Lich Faculty Practice Past Accepting new patients
Family Physicians at Lich Past Accepting new patients

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1720146699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 TURF RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813505",
            "telephone_number": "516-792-0789",
            "fax_number": "516-792-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365505",
            "telephone_number": "718-241-1513",
            "fax_number": "718-241-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDANO",
        "first_name": "ALBERT",
        "middle_name": "EDANO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "198162-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01591400",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.