Individual provider Active NPI

Renata Ann Witkowska, MD

  • Allergy & Immunology Physician
  • Newburgh, NY
National Provider Identifier
1043203474
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
002081 Issued in NY
Practice address
200 Lake St
Newburgh, NY 12550-5243
Phone
(845) 563-9990
Fax
(845) 563-9992
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 002081 NY Primary
Internal Medicine Physician 207R00000X 002081 NY

Addresses

Primary practice location

200 Lake St
Newburgh, NY 12550-5243

Mailing address

200 Lake St
Newburgh, NY 12550-5243
Phone (845) 563-9990

Other identifiers 2

IdentifierTypeStateIssuer
331832OtherMEDICARE
00472931MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060322000479 NY Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 7618985342 Reassigns benefits to 2 organizations
I20140625002381 NJ Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 7618985342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

154 Orange Ave
Suffern, NY 10901-6005
Phone (845) 357-1100

Hospital & facility affiliations

  • Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002081NYMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sudhir M Parikh M D P a Allergy & Immunology CurrentSince Mar 1, 2014 Accepting new patients
Night and Day Medical Associates PC CurrentSince Jan 1, 2012 Accepting new patients
Asthma & Allergy Medical Care PC Allergy & Immunology Past Accepting new patients
NPI 1811072390 Past Accepting new patients
Cornerstone Family Healthcare Past Accepting new patients
Hudson Vista Medical,PC Internal Medicine PastSince Aug 1, 2020 Accepting new patients

Locations

222 Schanck Rd
Ste 203
Freehold, NJ 07728
Phone (732) 431-3382

18 N 3rd Ave
Highland Park, NJ 08904
Phone (732) 545-0094

427 Fort Washington Ave
Apt 1C
New York, NY 10033
Phone (212) 740-4600

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGFIAA/Endpoint/CGFIAA
  • Direct secure messaging: renatawitkowska@cmdci.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGFIAA

Organizations & group practices 6

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 1

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1043203474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505243",
            "telephone_number": "845-563-9990",
            "fax_number": "845-563-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505243",
            "telephone_number": "845-563-9990",
            "fax_number": "845-563-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKOWSKA",
        "first_name": "RENATA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "002081",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "002081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "331832",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00472931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.