Individual provider Active NPI

Anessa Madraymootoo

  • Medical-Surgical Registered Nurse
  • Camp Hill, PA
National Provider Identifier
1093484990
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
736926 Issued in NY
Practice address
30 Hunter LN
Camp Hill, PA 17011-2400
Phone
(800) 748-3243
NPI assigned
Sep 13, 2021
Last updated
Sep 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 736926 NY Primary

Addresses

Primary practice location

30 Hunter LN
Camp Hill, PA 17011-2400

Mailing address

13512 117TH St
South Ozone Park, NY 11420-3621
Phone (347) 484-8047

Other practice location 1

8900 Van Wyck Expy
Jamaica, NY 11418-2897
Phone (718) 206-6000 ext. 4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
736926NYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1093484990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13512 117TH ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203621",
            "telephone_number": "347-484-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HUNTER LN",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112400",
            "telephone_number": "800-748-3243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114182897",
            "country_code": "US",
            "telephone_number": "718-206-6000 x4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADRAYMOOTOO",
        "first_name": "ANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "736926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.