Active NPI
Anna Zinchenko, NP
- Nurse Practitioner
- Brockton, MA
National Provider Identifier
1104801711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 216319
- Practice address
- 110 Liberty Street
Brockton, MA 02301 - Phone
- (508) 894-0400
- Fax
- (508) 894-0332
- NPI assigned
- Dec 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 216319 | MA | Primary |
Addresses
Primary practice location
110 Liberty Street
Brockton, MA 02301
Mailing address
680 Centre Street
Brockton, MA 02302
Phone (508) 941-7885
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216319 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Care of Boston Management Corporation | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Needham, MA
- NPI 1437196359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1104801711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 CENTRE STREET",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02302",
"telephone_number": "508-941-7885",
"fax_number": "508-941-6337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 LIBERTY STREET",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "508-894-0400",
"fax_number": "508-894-0332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZINCHENKO",
"first_name": "ANNA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-07",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "216319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.