Individual provider Active NPI

Fernando Arturo Ginebra, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1962466813
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
197158 Issued in NY
Practice address
132 Saint Nicholas Ave
Brooklyn, NY 11237-4167
Phone
(718) 484-8488
Fax
(718) 484-8487
NPI assigned
Apr 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 197158 NY
Pediatrics Physician 208000000X 197158 NY Primary

Addresses

Primary practice location

132 Saint Nicholas Ave
Brooklyn, NY 11237-4167

Mailing address

10 Surrey Rd
New Hyde Park, NY 11040-2036
Phone (516) 352-1819

Other identifiers 1

IdentifierTypeStateIssuer
01601770MedicaidNY

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
I20150527002186 NY Practitioner - Pediatric Medicine 2466772785 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197158NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC Pediatrics CurrentSince Mar 1, 2015 Accepting new patients
Wyckoff Heights Medical Center Current Accepting new patients
Ridgewood Pediatrics PC Pediatrics Past Accepting new patients

Locations

1419 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 455-4909

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBIHAA/Endpoint/CBIHAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBIHAA
  • Direct secure messaging: fernandoginebra@whmc.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1962466813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SURREY RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402036",
            "telephone_number": "516-352-1819",
            "fax_number": "718-424-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 SAINT NICHOLAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374167",
            "telephone_number": "718-484-8488",
            "fax_number": "718-484-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINEBRA",
        "first_name": "FERNANDO",
        "middle_name": "ARTURO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-16",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "197158",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "197158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01601770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.