Individual provider Active NPI

Anukware Ketosugbo, MD

  • Vascular Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1003835000
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
147545 Issued in NY
Practice address
1143 Nostrand Ave
Brooklyn, NY 11225-5532
Phone
(929) 790-6922
Fax
(718) 622-1367
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 147545 NY Primary

Addresses

Primary practice location

1143 Nostrand Ave
Brooklyn, NY 11225-5532

Mailing address

PO Box 5619
New York, NY 10087-5619
Phone (929) 790-6922

Other identifiers 1

IdentifierTypeStateIssuer
01036039MedicaidNY

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
I20091216000017 NY Practitioner - Thoracic Surgery 1658411053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1143 Nostrand Ave
Brooklyn, NY 11225-5532
Phone (718) 622-1301

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147545NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anukware Ketosugbo, MD, PC Vascular Surgery CurrentSince Jan 1, 2015 Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Jan 1, 2016 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1143 Nostrand Ave
Brooklyn, NY 11225
Phone (718) 693-4121

20 Plaza St E
Brooklyn, NY 11238
Phone (718) 622-5800

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1003835000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5619",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100875619",
            "telephone_number": "929-790-6922",
            "fax_number": "718-622-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112255532",
            "telephone_number": "929-790-6922",
            "fax_number": "718-622-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETOSUGBO",
        "first_name": "ANUKWARE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "147545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01036039",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.