Individual provider Active NPI

Anjana Hemraj Porwal, RPA-C

  • Medical Physician Assistant
  • Derby, NY
National Provider Identifier
1053638296
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
012825 Issued in NY
Practice address
6970 Erie Rd Ste a
Derby, NY 14047-9591
Phone
(716) 947-9147
Fax
(716) 947-9147
NPI assigned
Apr 28, 2010
Last updated
Apr 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 012825 NY Primary

Addresses

Primary practice location

6970 Erie Rd Ste a
Derby, NY 14047-9591

Mailing address

7770 Cameron Court
Niagara Falls, ONTARIO L2H3G9
CA
Phone (905) 356-7847

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000703 NY Practitioner - Physician Assistant 7113059312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wny Medical PCGroup PAC ID 9335191733, 44 clinicians

Practice addresses (Care Compare)

2600 S Park Ave
Lackawanna, NY 14218-1504
Phone (716) 822-2028

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012825NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southtowns Internal Medicine PC PastSince Jun 16, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: anjanap@wnymedical.medentdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1053638296",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "7770 CAMERON COURT",
            "city": "NIAGARA FALLS",
            "state": "ONTARIO",
            "postal_code": "L2H3G9",
            "telephone_number": "905-356-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 ERIE RD STE A",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479591",
            "telephone_number": "716-947-9147",
            "fax_number": "716-947-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORWAL",
        "first_name": "ANJANA",
        "middle_name": "HEMRAJ",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

Verify at the official NPI Registry.