Individual provider Active NPI

Alvin Donald Fried, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1912997297
Registry record updated Mar 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
035509 Issued in NY
Practice address
4802 10TH Ave
Division of Dentistry/ Maimonides Medical Center
Brooklyn, NY 11219-2844
Phone
(718) 283-7428
Fax
(718) 635-7073
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 035509 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Division of Dentistry/ Maimonides Medical Center
Brooklyn, NY 11219-2844

Mailing address

4802 10TH Ave
Division of Dentistry/ Maimonides Medical Center
Brooklyn, NY 11219-2844
Phone (718) 283-7428

Other identifiers 1

IdentifierTypeStateIssuer
01200215MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160205002268 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577577824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035509NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Interoperability endpoints

  • Direct secure messaging: alvin.fried.p1@direct.mmc.nextgenshare.com
  • Direct secure messaging: alvinfried@mai.allscriptsdirect.net

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426377600000",
    "number": "1912997297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "DIVISION OF DENTISTRY/ MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192844",
            "telephone_number": "718-283-7428",
            "fax_number": "718-635-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "DIVISION OF DENTISTRY/ MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192844",
            "telephone_number": "718-283-7428",
            "fax_number": "718-635-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "ALVIN",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2015-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01200215",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.