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ANDREA CORDOVA NP
NPI 1518349901
Nurse Practitioner - Pediatrics in Lake Grove, NY

Active since June 23, 2015PECOS Enrolled
4 SMITH HAVEN MALL STE 105, LAKE GROVE, NY 11755(631) 444-2599 Get Directions Write a Review

NPPES record last updated: February 18, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Andrea Cordova Np NPPES

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

ANDREA CORDOVA NP (NPI 1518349901) is an individual pediatrics provider in Lake Grove, New York, licensed in New York (623051) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1518349901
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameANDREA CORDOVACredential: NP
Location Address4 SMITH HAVEN MALL STE 105Lake Grove, NY 11755-1219
Mailing Address47 Forest AveLake Grove, NY 11755-1528 · (631) 379-5520
Phone(631) 444-2599
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJune 23, 2015
Last NPPES UpdateFebruary 18, 2026
NPPES CertifiedFebruary 18, 2026
✔ NPI 1518349901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in NY · 623051
4 SMITH HAVEN MALL STE 105, Lake Grove, NY 11755
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea Cordova Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9739662248
PECOS Enrollment IDI20260312003297
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11755 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

DAOD NIDAL PAK MD
Psychiatry & Neurology (Neurology)
4 SMITH HAVEN MALL STE 105
LAKE GROVE, NY 11755
Suffolk County (631) 444-2599
DANIELLE ANN DEVITO PNP
Nurse Practitioner (Pediatrics)
4 SMITH HAVEN MALL STE 105
LAKE GROVE, NY 11755
Suffolk County (631) 444-2599

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 Andrea Cordova's NPI number?

The NPI number for Andrea Cordova is 1518349901. It was assigned to this individual provider in the NPPES registry on June 23, 2015.

Where is Andrea Cordova located?

Andrea Cordova practices at 4 Smith Haven Mall Ste 105, Lake Grove, NY 11755. The listed phone number is (631) 444-2599.

What is Andrea Cordova's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Andrea Cordova enrolled in Medicare?

Yes. Andrea Cordova is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Andrea Cordova was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.