Individual provider Active NPI

Anna Sheina Gutman, M.D.

  • Nephrology Physician
  • Staten Island, NY
National Provider Identifier
1285013698
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
303751 Issued in NY
Practice address
1550 Richmond Ave Ste 205
Staten Island, NY 10314-1578
Phone
(718) 982-7800
Fax
(718) 982-7722
NPI assigned
May 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 303751 NY
Nephrology Physician 207RN0300X 303751 NY Primary

Addresses

Primary practice location

1550 Richmond Ave Ste 205
Staten Island, NY 10314-1578

Mailing address

97 New Dorp LN Ste a
Staten Island, NY 10306-2364
Phone (718) 876-6220

Other practice location 1

470 Seaview Ave
Staten Island, NY 10305-3401
Phone (718) 987-5940

Other identifiers 1

IdentifierTypeStateIssuer
05961591MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402001515 NY Practitioner - NephrologyPractitioner - Internal Medicine 9739425364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Nephrology Services PCGroup PAC ID 8729977202, 13 clinicians

Practice addresses (Care Compare)

12046 Queens Blvd
Kew Gardens, NY 11415-1204
Phone (718) 793-3341

1550 Richmond Ave
Suite 205
Staten Island, NY 10314-1578
Phone (718) 982-7800

25 Fanning St
Staten Island, NY 10314-5307
Phone (718) 289-7900

355 Bard Ave
Staten Island, NY 10310-1664
Phone (718) 818-2429

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-2000

470 Seaview Ave
Staten Island, NY 10305-3401
Phone (718) 987-5942

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Hospital & facility affiliations

  • Staten Island Dialysis Clinic/ Akc Dialysis facility, Staten Island, NY, CCN 332567
  • Island Rehabilitative Services - Clove Lakes Dialysis Dialysis facility, Staten Island, NY, CCN 332638
  • Dialyze Direct Brooklyn, NY Dialysis facility, Brooklyn, NY, CCN 332755
  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160
  • Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John M Pepe MD PLLC Nephrology CurrentSince Sep 5, 2023 Accepting new patients

Locations

1550 Richmond Ave
Staten Island, NY 10314
Phone (718) 370-7700

1550 Richmond Ave
Ste 205
Staten Island, NY 10314
Phone (718) 982-7800

Networks

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

Interoperability endpoints

  • Direct secure messaging: agutman66881@northwell.direct-ci.com

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.

Hospital & facility affiliations 5

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": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1285013698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 NEW DORP LN STE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062364",
            "telephone_number": "718-876-6220",
            "fax_number": "718-876-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 RICHMOND AVE STE 205",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141578",
            "telephone_number": "718-982-7800",
            "fax_number": "718-982-7722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053401",
            "country_code": "US",
            "telephone_number": "718-987-5940",
            "fax_number": "718-667-9708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "ANNA",
        "middle_name": "SHEINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "303751",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "303751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05961591",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.