Active NPI
Alvin Donald Fried, D.D.S.
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1912997297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 035509
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01200215 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160205002268 | NY | Order and Referring Only - Oral Surgery | 3577577824 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035509 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maimonides Medical Center | Current | Accepting new patients |
Locations
4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724
Interoperability endpoints
- alvin.fried.p1@direct.mmc.nextgenshare.com
- 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.
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1093777492
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.