Individual provider Active NPI

Annmarie McDonald, MD

  • Family Medicine Physician
  • South Ozone Park, NY
National Provider Identifier
1003976341
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
208705 Issued in NY
Practice address
13203 120TH Ave
South Ozone Park, NY 11420-2916
Phone
(718) 704-0953
Fax
(718) 228-2601
NPI assigned
Dec 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 208705 NY Primary

Addresses

Primary practice location

13203 120TH Ave
South Ozone Park, NY 11420-2916

Mailing address

13203 120TH Ave
South Ozone Park, NY 11420-2916
Phone (718) 704-0953

Other practice location 1

418 E 138th St
Bronx, NY 10454-3136
Phone (718) 414-9884

Other identifiers 1

IdentifierTypeStateIssuer
01947653MedicaidNY

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
I20071119000478 NY Practitioner - Family Practice 8224126628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13203 120TH Ave
South Ozone Park, NY 11420-2916
Phone (718) 704-0953

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208705NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TJH Medical Services, P.C. Family Medicine CurrentSince May 1, 2002 Accepting new patients
TJH Medical Services, PC Past Accepting new patients
Stephanie Carter-Robin DPM PC PastSince Mar 26, 2016 Accepting new patients

Locations

2060 Utica Ave
Brooklyn, NY 11234
Phone (718) 676-5309

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJADCA/Endpoint/HJADCA

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003976341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13203 120TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202916",
            "telephone_number": "718-704-0953",
            "fax_number": "718-228-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13203 120TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202916",
            "telephone_number": "718-704-0953",
            "fax_number": "718-228-2601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 E 138th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104543136",
            "country_code": "US",
            "telephone_number": "718-414-9884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ANNMARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "208705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01947653",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

Verify at the official NPI Registry.