Active NPI
Anna Marzena Lisowicz, NP
- Adult Health Nurse Practitioner
- Forest Hills, NY
National Provider Identifier
1275968364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F306357-1
- Practice address
- 10201 66TH Rd
Forest Hills, NY 11375-2029 - Phone
- (718) 830-4000
- NPI assigned
- Sep 7, 2013
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F306357-1 | NY | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | F340886-1 | NY |
Addresses
Primary practice location
10201 66TH Rd
Forest Hills, NY 11375-2029
Mailing address
6163 56TH St
Apt. 2ND Floor
Maspeth, NY 11378-3529
Phone (347) 420-9557
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F306357-1 | NY | MD | Adult Health Nurse Practitioner |
| F340886-1 | NY | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| North Shore - Lij Medical PC | Current | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Plandome, NY 11030
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
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 and National Provider Directory roles.
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- NPI 1053688572
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378512000000",
"number": "1275968364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6163 56TH ST",
"address_2": "APT. 2ND FLOOR",
"city": "MASPETH",
"state": "NY",
"postal_code": "113783529",
"telephone_number": "347-420-9557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10201 66TH RD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752029",
"telephone_number": "718-830-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISOWICZ",
"first_name": "ANNA",
"middle_name": "MARZENA",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-07",
"last_updated": "2013-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F306357-1",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NY",
"license": "F340886-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2013; 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.