Individual provider Active NPI

Anna C Pavlides, MD

  • Obstetrics & Gynecology Physician
  • Staten Island, NY
National Provider Identifier
1508805904
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
206780 Issued in NY
Practice address
2 Teleport Dr Ste 207
Staten Island, NY 10311-1004
Phone
(718) 273-5500
Fax
(718) 273-3232
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 206780 NY Primary

Addresses

Primary practice location

2 Teleport Dr Ste 207
Staten Island, NY 10311-1004

Mailing address

2 Teleport Dr Ste 207
Staten Island, NY 10311-1004
Phone (718) 273-5500

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
I20040910000012 NY Practitioner - Obstetrics/Gynecology 8527034503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Stony Brook, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

355 Bard Ave
Staten Island, NY 10310-1664
Phone (718) 818-1234

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160
  • Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206780NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Aug 12, 2024 Accepting new patients
Amboy Medical Practice PC Obstetrics & Gynecology CurrentSince Aug 12, 2024 Accepting new patients
Richmond Medical Center Past Accepting new patients
Richmond University Medical Center Past Accepting new patients

Locations

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

2 Teleport Dr
Ste 207
Staten Island, NY 10311
Phone (718) 273-5500

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: apavlides67353@northwell.direct-ci.com
  • Direct secure messaging: anna.pavlides.1@19656.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1508805904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TELEPORT DR STE 207",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103111004",
            "telephone_number": "718-273-5500",
            "fax_number": "718-273-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TELEPORT DR STE 207",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103111004",
            "telephone_number": "718-273-5500",
            "fax_number": "718-273-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIDES",
        "first_name": "ANNA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "206780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.