Individual provider Active NPI

Anna Suponya, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1043210669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
229325-1 Issued in NY
Practice address
9920 4TH Ave
Suite 206
Brooklyn, NY 11209-8333
Phone
(718) 238-8373
Fax
(718) 238-8375
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 229325-1 NY Primary

Addresses

Primary practice location

9920 4TH Ave
Suite 206
Brooklyn, NY 11209-8333

Mailing address

9920 4TH Ave
Suite 206
Brooklyn, NY 11209-8333
Phone (718) 238-8373

Other identifiers 1

IdentifierTypeStateIssuer
02575588MedicaidNY

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
I20040521000495 NY Practitioner - Internal Medicine 2365433927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9920 4TH Ave
Suite 206
Brooklyn, NY 11209-8328
Phone (718) 238-8373

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229325-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Suponya, MD, PC Internal Medicine CurrentSince Aug 1, 2011 Accepting new patients

Locations

9920 4th Ave
Ste 206
Brooklyn, NY 11209
Phone (718) 238-8373

Interoperability endpoints

  • Direct secure messaging: ans9354@direct.nyp.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/DBAJAA/Endpoint/DBAJAA

Organizations & group practices 1

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 7

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043210669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 4TH AVE",
            "address_2": "SUITE 206",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098333",
            "telephone_number": "718-238-8373",
            "fax_number": "718-238-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 4TH AVE",
            "address_2": "SUITE 206",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098333",
            "telephone_number": "718-238-8373",
            "fax_number": "718-238-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPONYA",
        "first_name": "ANNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "229325-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02575588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.