Individual provider Active NPI

Rachel Leah Waldron, MD

  • Emergency Medicine Physician
  • Flushing, NY
National Provider Identifier
1861415028
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
209970 Issued in NY
Practice address
56-45 Main Street
Ny Hospital Medical Center of Queens Emergency Dept
Flushing, NY 11355
Phone
(718) 670-1231
Fax
(610) 617-6280
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 209970 NY Primary

Addresses

Primary practice location

56-45 Main Street
Ny Hospital Medical Center of Queens Emergency Dept
Flushing, NY 11355

Mailing address

PO Box 430
Emergency Practice Plan
Flushing, NY 11352
Phone (610) 668-6491

Other identifiers 1

IdentifierTypeStateIssuer
02102243MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150828002190 GA Practitioner - Emergency Medicine 0345420089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Emergency Associates Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients
New York Hospital Medical Center of Queens Emergency Medicine Past Accepting new patients

Locations

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861415028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "address_2": "EMERGENCY PRACTICE PLAN",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11352",
            "telephone_number": "610-668-6491",
            "fax_number": "610-617-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56-45 MAIN STREET",
            "address_2": "NY HOSPITAL MEDICAL CENTER OF QUEENS EMERGENCY DEPT",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-670-1231",
            "fax_number": "610-617-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "RACHEL",
        "middle_name": "LEAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "209970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02102243",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.