Active NPI
Anna Varghese, MD
- Internal Medicine Physician
- Pomona, NY
National Provider Identifier
1194986372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR.0051386
- Practice address
- 54 Tamarack LN
Pomona, NY 10970-2012 - Phone
- (848) 641-8629
- NPI assigned
- Jun 20, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | DR.0051386 | CO | Primary |
Addresses
Primary practice location
54 Tamarack LN
Pomona, NY 10970-2012
Mailing address
54 Tamarack LN
Pomona, NY 10970-2012
Phone (848) 641-8629
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51857553 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0051386 | CO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alaska Native Tribal Health Consortium | Current | Accepting new patients | |
| DHHS, PHS, Naihs, Gallup Indian Medical Center | Current | Accepting new patients | |
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current | Accepting new patients |
Locations
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326
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.
-
- General Acute Care Hospital
- Gallup, NM
- NPI 1225002322
TX
-
- Federal Public Health Clinic/Center
- Tohatchi, NM
- NPI 1902875594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1194986372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 TAMARACK LN",
"city": "POMONA",
"state": "NY",
"postal_code": "109702012",
"telephone_number": "848-641-8629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 TAMARACK LN",
"city": "POMONA",
"state": "NY",
"postal_code": "109702012",
"telephone_number": "848-641-8629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGHESE",
"first_name": "ANNA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-20",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0051386",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51857553",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.