Individual provider Active NPI

Cindy-Anne Carla Williams, FNP

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1437393253
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
342833 Issued in NY
Practice address
1052 Liberty Ave
Brooklyn, NY 11208-2913
Phone
(631) 816-8054
NPI assigned
Apr 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 578668-1 NY
Family Nurse Practitioner 363LF0000X SP018573 PA
Family Nurse Practitioner 363LF0000X 342833 NY
Family Medicine Physician 207Q00000X 342833 NY Primary

Addresses

Primary practice location

1052 Liberty Ave
Brooklyn, NY 11208-2913

Mailing address

763-5 Eastern Parkway
Apt E-17
Brooklyn, NY 11213
Phone (631) 816-8054

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180427000293 NY Practitioner - Nurse Practitioner 9436413432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
578668-1NYMDGeneral Practice Registered Nurse
342833NYMDFamily Nurse Practitioner
SP018573PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elivasion Health & Wellness, LLC Family Current Accepting new patients
Park Avenue Pediatrics, P.C. CurrentSince Oct 1, 2022 Accepting new patients
Crown Heights Medical, P.C. CurrentSince Oct 11, 2022 Accepting new patients
Divinity Medical Services PLLC CurrentSince Feb 12, 2024 Accepting new patients
Ny Family Medical Docs PC Family Medicine Past Accepting new patients

Locations

3400 Cannon Pl
Bronx, NY 10463
Phone (718) 694-9000

332 E 149th St
Bronx, NY 10451
Phone (347) 329-4010

314 Bradley Ave
Staten Island, NY 10314
Phone (718) 494-1700

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Interoperability endpoints

  • Direct secure messaging: cwilliams17822@prd.direct.tbh.org
  • Direct secure messaging: cwilliams43951@direct.acpny.com

Organizations & group practices 5

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1437393253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763-5 EASTERN PARKWAY",
            "address_2": "APT E-17",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11213",
            "telephone_number": "631-816-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082913",
            "telephone_number": "631-816-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CINDY-ANNE",
        "middle_name": "CARLA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "578668-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018573",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342833",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "342833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.