Individual provider Active NPI

Elena Annopolsky, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1316900798
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD067857-L Issued in PA
Practice address
2375 Woodward St Ste 112
Philadelphia, PA 19115-5105
Phone
(215) 722-6022
Fax
(215) 598-7332
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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 MD-067857-L PA
Internal Medicine Physician 207R00000X MD067857-L PA Primary

Addresses

Primary practice location

2375 Woodward St Ste 112
Philadelphia, PA 19115-5105

Mailing address

14 Buckmanville Rd
Newtown, PA 18940-3112
Phone (267) 716-1422

Other identifiers 1

IdentifierTypeStateIssuer
0017564570005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101104000926 PA Practitioner - Internal Medicine 3971797861 Reassigns benefits to 1 organization
Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avellina Inc.Group PAC ID 4385715788, 3 clinicians

Practice addresses (Care Compare)

2375 Woodward St
Suite 112N
Philadelphia, PA 19115-5105
Phone (215) 676-9223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-067857-LPAMDInternal Medicine Physician
MD067857-LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avellina Inc. Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients

Locations

2375 Woodward St
Ste 112
Philadelphia, PA 19115
Phone (215) 676-4947

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1316900798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BUCKMANVILLE RD",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189403112",
            "telephone_number": "267-716-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 WOODWARD ST STE 112",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191155105",
            "telephone_number": "215-722-6022",
            "fax_number": "215-598-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNOPOLSKY",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD-067857-L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD067857-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017564570005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.