Fernando Echeverry

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2 Roosevelt Ave
Sysosset, NY 11791

Phone

(516) 496-4460

Fax

(516) 921-4432

NPI assigned

Jun 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Luis Fernando Echeverry Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Sansharc Inc.

  • Specialist
  • Syosset, NY
  • NPI 1528619046
  NPD (past)

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1801159223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 STREET",
            "address_2": "33-27",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611143",
            "telephone_number": "917-834-3061",
            "fax_number": "347-502-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ROOSEVELT AVE",
            "city": "SYSOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-496-4460",
            "fax_number": "516-921-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHEVERRY",
        "first_name": "FERNANDO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUIS",
            "last_name": "ECHEVERRY",
            "middle_name": "FERNANDO",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.