Individual provider Active NPI

Anastasia Maria Liotopoulos, CPNP-PC

  • Pediatric Nurse Practitioner
  • Bayside, NY
National Provider Identifier
1326874678
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383688 Issued in NY
Practice address
21031 26TH Ave
Bayside, NY 11360-1949
Phone
(718) 747-5437
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F383688 NY Primary

Addresses

Primary practice location

21031 26TH Ave
Bayside, NY 11360-1949

Mailing address

4311 195TH St
Flushing, NY 11358-3518
Phone (917) 502-2409

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

State licenses

LicenseStateTypeSpecialty
F383688NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics PC Past Accepting new patients
Allied Physicians Group, PLLC Past Accepting new patients
PM Pediatrics of Bayside, PLLC Past Accepting new patients

Organizations & group practices 4

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": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1326874678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 195TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583518",
            "telephone_number": "917-502-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21031 26TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601949",
            "telephone_number": "718-747-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIOTOPOULOS",
        "first_name": "ANASTASIA",
        "middle_name": "MARIA",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.