Individual provider Active NPI

Anna Zhivotovsky II, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1093780538
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
232757 Issued in NY
Practice address
1559 York Ave
New York, NY 10028-6001
Phone
(212) 585-3329
Fax
(212) 585-3717
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 232757 NY Primary

Addresses

Primary practice location

1559 York Ave
New York, NY 10028-6001

Mailing address

14 Wall St FL 9
New York, NY 10005-2178

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
I20240416002853 NY Practitioner - Pediatric Medicine 7517306160 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Mar 1, 2024 Accepting new patients
New York University Pediatrics CurrentSince Mar 1, 2024 Accepting new patients

Locations

1559 York Ave
New York, NY 10028
Phone (212) 585-3329

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: azhivotovsky636276@nyumc.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1093780538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WALL ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286001",
            "telephone_number": "212-585-3329",
            "fax_number": "212-585-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHIVOTOVSKY",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "232757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.