Individual provider Active NPI

Andrei Carasca, MD

  • Clinical Neurophysiology Physician
  • New York, NY
National Provider Identifier
1992703391
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
196096 Issued in NY
Practice address
875 5TH Ave
New York, NY 10065-4952
Phone
(212) 288-4181
Fax
(212) 288-4011
NPI assigned
Jul 8, 2005
Reactivated
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 196096 NY Primary

Addresses

Primary practice location

875 5TH Ave
New York, NY 10065-4952

Mailing address

875 5TH Ave
New York, NY 10065-4952
Phone (212) 288-4181

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
I20040721001552 NY Practitioner - Neurology 0749260644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

875 5TH Ave
1B
New York, NY 10065-4952
Phone (212) 288-4181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196096NYMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andrei Carasca Neurology PLLC Clinical Neurophysiology CurrentSince Feb 1, 2005 Accepting new patients
Booth Medical Associates PC Past Accepting new patients
Dac Physician Services,PC PastSince May 3, 2004 Accepting new patients
Newyork-Presbyterian/Queens Past Accepting new patients

Networks

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

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1992703391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654952",
            "telephone_number": "212-288-4181",
            "fax_number": "212-288-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654952",
            "telephone_number": "212-288-4181",
            "fax_number": "212-288-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARASCA",
        "first_name": "ANDREI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2011-08-10",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "196096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.