Individual provider Active NPI

Sandra Fernandes, M.D.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1972861409
Registry record updated Apr 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
279473 Issued in NY
Practice address
495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706
Phone
(833) 904-2273
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 279473 NY Primary

Addresses

Primary practice location

495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706

Mailing address

495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706
Phone (833) 904-2273

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

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
I20150824000911 NY Practitioner - Family Practice 3971818741 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 12, 2015 Accepting new patients
Advantagecare Physicians PC CurrentSince Feb 1, 2021 Accepting new patients
Advantagecare Physicians PC Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Sun River Health Inc. CurrentSince Aug 1, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Jun 12, 2015 Accepting new patients
Sun River Health Inc Current Accepting new patients
Cityblock Medical Practice, P.a. Family Medicine PastSince Jul 15, 2021 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

111 E 210th St
Bronx, NY 10467

3544 Jerome Ave
Bronx, NY 10467
Phone (718) 920-2007

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

546 Eastern Pkwy
Brooklyn, NY 11225
Phone (718) 604-4800

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 7

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": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619308800000",
    "number": "1972861409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 FLATBUSH AVE STE C5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253706",
            "telephone_number": "833-904-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 FLATBUSH AVE STE C5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253706",
            "telephone_number": "833-904-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "SANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2021-04-25",
        "certification_date": "2021-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "279473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.