Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. ANDREW J. DUARTE MD
NPI 1396270526
Physical Medicine & Rehabilitation in New York, NY

Active since April 25, 2017PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
550 1ST AVE, NEW YORK, NY 10016(646) 929-7870 Get Directions Write a Review

NPPES record last updated: October 5, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 5, 2026, Aug 16, 2022, Jul 28, 2022 and 3 more (6 updates tracked since 2017).

About Dr. Andrew J. Duarte Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANDREW J. DUARTE MD (NPI 1396270526) is an individual physical medicine & rehabilitation provider in New York, New York, licensed in Massachusetts (292090) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Health - Harrington Hospital, and is a graduate of University Of Connecticut School Of Medicine (2017).

NPPES Registry Identity

NPI1396270526
Entity TypeIndividualMale
Primary Taxonomy208100000X
Provider Legal NameDR. ANDREW J. DUARTECredential: MD
Location Address550 1ST AVENew York, NY 10016
Mailing AddressPo Box 415348Boston, MA 02241-5348
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 2017
Enumeration DateApril 25, 2017
Last NPPES UpdateOctober 5, 20266 updates tracked since enumeration
NPPES CertifiedOctober 5, 2026
✔ NPI 1396270526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Medicine & RehabilitationAllopathic & Osteopathic Physicians
Taxonomy Code208100000X
License✔ Licensed in MA · 292090
Definition
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
550 1ST AVE, New York, NY 10016

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Andrew J. Duarte Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951673110
PECOS Enrollment IDI20220811002281
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Andrew Duarte reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Urgent Care
78 SUTTON AVE
Oxford, MA 01540
  • Reassigned Medicare billing, Massachusetts enrollment
  • 2,902 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 24

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
237 services166 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
185 services126 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
101 services101 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
86 services66 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
79 services53 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
63 services63 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Umass Memorial Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220019
Location100 South StreetSouthbridge, MA 01550 · Worcester County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
550 1ST AVE
NEW YORK, NY 10016
Emergency Medicine (Pediatric Emergency Medicine)
550 1ST AVE
NEW YORK, NY 10016
Allergy & Immunology
550 1ST AVE, NBV 16N30, INTERNAL MEDICINE RESIDENCY PROGRAM
NEW YORK, NY 10016
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
Radiology (Vascular & Interventional Radiology)
550 1ST AVE
NEW YORK, NY 10016
Surgery
550 1ST AVE
NEW YORK, NY 10016
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Duarte's NPI number?

The NPI number for Andrew Duarte is 1396270526. It was assigned to this individual provider in the NPPES registry on April 25, 2017.

Where is Andrew Duarte located?

Andrew Duarte practices at 550 1st Ave, New York, NY 10016. The listed phone number is (646) 929-7870.

What is Andrew Duarte's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.

Is Andrew Duarte enrolled in Medicare?

Yes. Andrew Duarte is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Andrew Duarte's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Duarte reassigns Medicare benefits to Umass Memorial Medical Group, Inc. (Oxford, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Duarte's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrew Duarte accept?

Health plans from Anthem Blue Cross and Blue Shield list Andrew Duarte as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Andrew Duarte affiliated with any hospitals?

According to CMS data, Andrew Duarte is affiliated with Umass Memorial Health - Harrington Hospital and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Andrew Duarte was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.