Individual provider Active NPI

Anu Kothari, MD

  • Obstetrics & Gynecology Physician
  • Hicksville, NY
National Provider Identifier
1629008180
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
159391 Issued in NY
Practice address
111 W Old Country Rd Ste 102
Hicksville, NY 11801-4036
Phone
(516) 822-4600
Fax
(516) 822-4602
NPI assigned
Jul 3, 2006
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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 159391 NY Primary

Addresses

Primary practice location

111 W Old Country Rd Ste 102
Hicksville, NY 11801-4036

Mailing address

1000 Zeckendorf Blvd
Garden City, NY 11530-2133
Phone (516) 542-6880

Other identifiers 1

IdentifierTypeStateIssuer
01451110MedicaidNY

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
I20210907003499 NY Practitioner - Obstetrics/Gynecology 3779987516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 W Old Country Rd
Suite 102
Hicksville, NY 11801-4036
Phone (516) 822-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159391NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Jewish Medical Center Past Accepting new patients
Qlimg Rochdale Village OB/GYN Office Obstetrics & Gynecology Past Accepting new patients
Queens Long Island Medical Group, P.C. Obstetrics & Gynecology Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: anu.kothari@coghp-ny.direct.office.nextgen.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1629008180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ZECKENDORF BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302133",
            "telephone_number": "516-542-6880",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W OLD COUNTRY RD STE 102",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014036",
            "telephone_number": "516-822-4600",
            "fax_number": "516-822-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "ANU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "159391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01451110",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.