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

ANDRAEA KAMILLE MERCADO DIZON
NPI 1811755648
Nurse Practitioner - Family in New York, NY

Q: What is Andraea Kamille Dizon's NPI number?

The NPI number for Andraea Kamille Dizon is 1811755648. It was assigned to this individual provider in the NPPES registry on March 7, 2024.

Q: What is Andraea Kamille Dizon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since March 07, 2024PECOS Enrolled

130 E 77TH ST FL 8, NEW YORK, NY 10075(212) 434-6400 Get Directions Write a Review

NPPES record last updated: September 22, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Sep 22, 2026, Mar 7, 2024 (2 updates tracked since 2024).

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About Andraea Kamille Mercado Dizon NPPES

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

ANDRAEA KAMILLE MERCADO DIZON (NPI 1811755648) is an individual family provider in New York, New York, licensed in New York (F352988-01) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS, is affiliated with Lenox Hill Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1811755648

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameANDRAEA KAMILLE MERCADO DIZON

Location Address130 E 77TH ST FL 8New York, NY 10075-1851

Mailing Address130 E 77th St Fl 8New York, NY 10075-1851 · (212) 434-6400

Phone(212) 434-6400

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 7, 2024

Last NPPES UpdateSeptember 22, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2026

✔ NPI 1811755648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · F352988-01

130 E 77TH ST FL 8, New York, NY 10075

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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 and accepts Medicare assignment

Andraea Kamille Mercado Dizon 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 ID749712214

PECOS Enrollment IDI20241022003311

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.

Areas of Expertise CMS Part B claims

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.

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.

28 services28 patients

Hospital Affiliations CMS Care Compare

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

Lenox Hill Hospital

Acute Care Hospitals · New York, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330119

Location100 East 77th StreetNew York, NY 10021 · New York County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10075 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

$102.04 typical visit price

range $65.69 – $198.19

Typical copayment $25.51 (range $16.42 – $49.54)

Most-billed visit code 99203

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

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 5

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

VICTORIA LAUREN VACHRIS

Physician Assistant