Individual provider Active NPI

Annie Samina Aziz, MD

  • Family Medicine Physician
  • Newburgh, NY
National Provider Identifier
1093874620
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
214696 Issued in NY
Practice address
200 Lake Street
Newburgh, NY 12550-5243
Phone
(845) 863-9800
Fax
(845) 565-6349
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 214696 NY Primary

Addresses

Primary practice location

200 Lake Street
Newburgh, NY 12550-5243

Mailing address

200 Lake Street
Newburgh, NY 12550-5243
Phone (845) 863-9800

Other identifiers 1

IdentifierTypeStateIssuer
02087938MedicaidNY

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
I20111012000774 NY Practitioner - Family Practice 0840462065 Practice locations: Newburgh, NY

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1093874620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAKE STREET",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505243",
            "telephone_number": "845-863-9800",
            "fax_number": "845-565-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAKE STREET",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505243",
            "telephone_number": "845-863-9800",
            "fax_number": "845-565-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZ",
        "first_name": "ANNIE",
        "middle_name": "SAMINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02087938",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.