Individual provider Active NPI

Alexa Goldfarb, D.O.

  • Pediatric Gastroenterology Physician
  • Bronx, NY
National Provider Identifier
1881125136
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
302998 Issued in NY
Practice address
3411 Wayne Ave
Bronx, NY 10467-2509
Phone
(718) 741-2487
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 302998 NY
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Gastroenterology Physician 2080P0206X 302998 NY Primary

Addresses

Primary practice location

3411 Wayne Ave
Bronx, NY 10467-2509

Mailing address

3411 Wayne Ave
Bronx, NY 10467-2509
Phone (203) 858-9525

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725000568 NY Practitioner - GastroenterologyPractitioner - Pediatric Medicine 1658643796 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302998NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Jun 16, 2023 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Jun 16, 2023 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3411 Wayne Ave
Bronx, NY 10467
Phone (718) 920-2680

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

Networks

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

Interoperability endpoints

  • Direct secure messaging: agoldfarb@montefioredirect.com
  • Direct secure messaging: alexa.goldfarb.1@18107.direct.athenahealth.com

Organizations & group practices 4

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1881125136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672509",
            "telephone_number": "203-858-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672509",
            "telephone_number": "718-741-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "ALEXA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "302998",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "302998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.