Individual provider Active NPI

Annie Tayinah Thermidor, NP

  • Acute Care Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1174967152
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F4306841 Issued in NY
Practice address
222 Lenox Rd
2Z
Brooklyn, NY 11226-2179
Phone
(347) 489-9409
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F4306841 NY Primary

Addresses

Primary practice location

222 Lenox Rd
2Z
Brooklyn, NY 11226-2179

Mailing address

222 Lenox Rd
2Z
Brooklyn, NY 11226-2179
Phone (347) 489-9409

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190730000817 NY Practitioner - Nurse Practitioner 7719213727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F4306841NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2019 Accepting new patients
New York University CurrentSince Jul 1, 2019 Accepting new patients
Iri: Innovative Resources for Independence Past Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

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

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: athermidor10836@nyumc.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1174967152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 LENOX RD",
            "address_2": "2Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262179",
            "telephone_number": "347-489-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 LENOX RD",
            "address_2": "2Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262179",
            "telephone_number": "347-489-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERMIDOR",
        "first_name": "ANNIE",
        "middle_name": "TAYINAH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F4306841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.