Individual provider Active NPI

Anna Petrovna Puzyrkova

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1184248395
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0026029 Issued in DE
Practice address
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone
(314) 768-8778
NPI assigned
Jun 3, 2020
Last updated
Apr 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X C1-0026029 DE Primary

Addresses

Primary practice location

6420 Clayton Rd
Saint Louis, MO 63117-1811

Mailing address

1St Novokuzminskaya Street 11 Apt 18
Moscow, MOSCOW 109377
RU

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20230515002709 DE Practitioner - Internal Medicine 3577929637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Delaware IncGroup PAC ID 9638312572, 94 clinicians

Practice addresses (Care Compare)

640 S State St
Dover, DE 19901-3530
Phone (302) 674-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.66 of 100Reported as group
Quality
81.55
Improvement activities
40
Cost
75.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0026029DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Delaware, Inc Internal Medicine CurrentSince Apr 5, 2023 Accepting new patients
Bayhealth Medical Center, Inc. Past Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1184248395",
    "addresses": [
        {
            "country_code": "RU",
            "country_name": "Russian Federation",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1ST NOVOKUZMINSKAYA STREET 11 APT 18",
            "city": "MOSCOW",
            "state": "MOSCOW",
            "postal_code": "109377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUZYRKOVA",
        "first_name": "ANNA",
        "middle_name": "PETROVNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0026029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.