Individual provider Active NPI

Anne Gudi, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1467425934
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
360227 Issued in NY
Practice address
502A 9TH Street
Brooklyn, NY 11215
Phone
(718) 499-3636
Fax
(718) 788-0596
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F000016 NY
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 360227 NY Primary

Addresses

Primary practice location

502A 9TH Street
Brooklyn, NY 11215

Mailing address

502A 9TH Street
Brooklyn, NY 11215
Phone (718) 499-3636

Other identifiers 1

IdentifierTypeStateIssuer
01419185MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715000997 NY Practitioner - Certified Nurse Midwife (CNM) 9234118050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F000016NYMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1467425934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502A 9TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-499-3636",
            "fax_number": "718-788-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502A 9TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-499-3636",
            "fax_number": "718-788-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDI",
        "first_name": "ANNE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F000016",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "360227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01419185",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.