Active NPI
Mayra Nadal, MD
- Pediatrics Physician
- Brentwood, NY
National Provider Identifier
1790781128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 222213
- Practice address
- 27 Wicks Rd
Brentwood, NY 11717-4213 - Phone
- (631) 231-5070
- Fax
- (631) 435-3288
- NPI assigned
- Jun 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 222213 | NY | Primary |
Addresses
Primary practice location
27 Wicks Rd
Brentwood, NY 11717-4213
Mailing address
27 Wicks Rd
Brentwood, NY 11717-4213
Phone (631) 231-5070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02404511 | Medicaid | NY |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brentwood Pediatric & Adolescent Associates, PC | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H9678
Interoperability endpoints
- mayra.nadal@bpaa.eclinicaldirectplus.com
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 and National Provider Directory roles.
-
- Pediatric Adolescent Medicine Physician
- Bay Shore, NY
- NPI 1578753075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1790781128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 WICKS RD",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117174213",
"telephone_number": "631-231-5070",
"fax_number": "631-435-3288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 WICKS RD",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117174213",
"telephone_number": "631-231-5070",
"fax_number": "631-435-3288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADAL",
"first_name": "MAYRA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "222213",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02404511",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.