Individual provider Active NPI

Erica L. Edmund, FNP

  • Family Nurse Practitioner
  • Astoria, NY
National Provider Identifier
1811261605
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336615 Issued in NY
Practice address
3101 Ditmars Blvd
Astoria, NY 11105-2304
Phone
(866) 389-2727
NPI assigned
Feb 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 336615 NY
Family Nurse Practitioner 363LF0000X 336615 NY Primary

Addresses

Primary practice location

3101 Ditmars Blvd
Astoria, NY 11105-2304

Mailing address

3101 Ditmars Blvd
Astoria, NY 11105-2304

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
I20171130002818 NY Practitioner - Nurse Practitioner 0941577357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Group of New York PCGroup PAC ID 2567642044, 61 clinicians

Practice addresses (Care Compare)

107 S Country Rd
Bellport, NY 11713-2523
Phone (866) 389-2727

3101 Ditmars Blvd
Astoria, NY 11105-2304
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
Medical Group of New York, P.C. Family CurrentSince Sep 28, 2017 Accepting new patients

Locations

3101 Ditmars Blvd
Astoria, NY 11105
Phone (718) 545-0128

107 S Country Rd
Bellport, NY 11713
Phone (631) 286-2222

7209 Northern Blvd
Jackson Heights, NY 11372
Phone (718) 533-8434

7960 Metropolitan Ave
Middle Village, NY 11379
Phone (718) 326-4910

Networks

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

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": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1811261605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 DITMARS BLVD",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 DITMARS BLVD",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052304",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUND",
        "first_name": "ERICA",
        "middle_name": "L.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "336615",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.