Active NPI
Anita Lynn Dormer, M.D.
- Specialist
- New York, NY
National Provider Identifier
1205095023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 217683-1
- Practice address
- 121 E 71St Street
Ground Floor
New York, NY 10021-4201 - Phone
- (212) 535-5905
- Fax
- (212) 249-7654
- NPI assigned
- Jun 6, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 217683-1 | NY | Primary |
Addresses
Primary practice location
121 E 71St Street
Ground Floor
New York, NY 10021-4201
Mailing address
121 E 71St St
Ground Floor
New York, NY 10021-4201
Phone (212) 535-5905
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217683-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1205095023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 E 71ST ST",
"address_2": "GROUND FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214201",
"telephone_number": "212-535-5905",
"fax_number": "212-249-7654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 E 71ST STREET",
"address_2": "GROUND FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214201",
"telephone_number": "212-535-5905",
"fax_number": "212-249-7654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORMER",
"first_name": "ANITA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-06",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "217683-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.