Individual provider Active NPI

Audrey Stedford, DNP

  • Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1811019201
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
303562 Issued in NY
Practice address
2035 Ralph Ave Ste A8
Brooklyn, NY 11234-5300
Phone
(646) 631-9103
Fax
(347) 352-3238
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 303562 NY Primary

Addresses

Primary practice location

2035 Ralph Ave Ste A8
Brooklyn, NY 11234-5300

Mailing address

966 E 102ND St
Brooklyn, NY 11236-2620
Phone (646) 631-9103

Other practice location 1

8931 161st St Lbby Suite
Jamaica, NY 11432-6140
Phone (646) 631-9103

Other identifiers 1

IdentifierTypeStateIssuer
04359606MedicaidNY

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
I20140813000373 NY Practitioner - Nurse Practitioner 4789801812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2035 Ralph Ave
Suite A8
Brooklyn, NY 11234-5300
Phone (718) 968-2059

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steddy Healthcare NP in Adult Health PLLC Single Specialty CurrentSince Aug 1, 2014 Accepting new patients

Locations

2035 Ralph Ave
Ste A8
Brooklyn, NY 11234
Phone (646) 631-9103

8931 161st St
Jamaica, NY 11432
Phone (718) 291-6161

8931 161st St
Lbby
Jamaica, NY 11432
Phone (646) 631-9103

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: audrey.stedford.1@22563.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AGFHDD/Endpoint/AGFHDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1811019201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 E 102ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362620",
            "telephone_number": "646-631-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 RALPH AVE STE A8",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345300",
            "telephone_number": "646-631-9103",
            "fax_number": "347-352-3238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8931 161st St Lbby Suite",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114326140",
            "country_code": "US",
            "telephone_number": "646-631-9103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEDFORD",
        "first_name": "AUDREY",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "303562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04359606",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.