Individual provider Active NPI

Anna Plourde

  • Medical Microbiology Physician
  • Chicago, IL
National Provider Identifier
1154697894
Registry record updated Apr 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Microbiology PhysicianTaxonomy code 207ZM0300X
License
036.149075 Issued in IL
Practice address
5841 S Maryland Ave # Mc3083
Chicago, IL 60637-1443
Phone
(847) 570-2019
NPI assigned
Mar 27, 2012
Last updated
Apr 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Microbiology Physician 207ZM0300X 036.149075 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc3083
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

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
I20201002000340 NY Practitioner - Pathology 9537401104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Massachusetts Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-2744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.149075ILMDMedical Microbiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Current Accepting new patients

Locations

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

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, 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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555804800000",
    "number": "1154697894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC3083",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "847-570-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOURDE",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2019-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "IL",
            "license": "036.149075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.