Individual provider Active NPI

Andrea L Fry, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1780717868
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335145 Issued in NY
Practice address
160 E 34TH St
3Rd Floor
New York, NY 10016
Phone
(212) 731-6699
Fax
(212) 731-6051
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X F335145 NY
Family Nurse Practitioner 363LF0000X 335145 NY Primary

Addresses

Primary practice location

160 E 34TH St
3Rd Floor
New York, NY 10016

Mailing address

160 E 34TH St
3Rd Floor
New York, NY 10016-4744
Phone (212) 731-6699

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
I20121212000528 NY Practitioner - Nurse Practitioner 2264684521 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F335145NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Surgery Group CurrentSince Nov 24, 2019 Accepting new patients
Memorial Medical Consultation Group CurrentSince Jan 1, 2021 Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Organizations & group practices 2

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1780717868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E 34TH ST",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164744",
            "telephone_number": "212-731-6699",
            "fax_number": "212-731-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E 34TH ST",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-731-6699",
            "fax_number": "212-731-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "ANDREA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "F335145",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.