Individual provider Active NPI

Annamaria Kontor, M.D.

  • Pediatrics Physician
  • Penfield, NY
National Provider Identifier
1669484911
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
227285 Issued in NY
Practice address
2067 Fairport Nine Mile Point Rd
Suite 110
Penfield, NY 14526-1752
Phone
(585) 922-0460
Fax
(585) 922-0470
NPI assigned
Aug 13, 2006
Last updated
Jan 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 227285 NY Primary

Addresses

Primary practice location

2067 Fairport Nine Mile Point Rd
Suite 110
Penfield, NY 14526-1752

Mailing address

90 Valewood Run
Penfield, NY 14526-2809
Phone (585) 388-7897

Other identifiers 1

IdentifierTypeStateIssuer
02377888MedicaidNY

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
I20040519000294 NY Practitioner - Pediatric Medicine 0648261776 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227285NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trillium Health, Inc CurrentSince May 27, 2018 Accepting new patients
Trillium Health, Inc CurrentSince May 27, 2018 Accepting new patients

Locations

170 Science Pkwy
Rochester, NY 14620
Phone (585) 545-7200

259 Monroe Ave
Rochester, NY 14607
Phone (585) 325-2280

Interoperability endpoints

  • Direct secure messaging: akontor566067@direct.urmc.rochester.edu

Organizations & group practices 2

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1669484911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 VALEWOOD RUN",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262809",
            "telephone_number": "585-388-7897",
            "fax_number": "585-388-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 FAIRPORT NINE MILE POINT RD",
            "address_2": "SUITE 110",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261752",
            "telephone_number": "585-922-0460",
            "fax_number": "585-922-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONTOR",
        "first_name": "ANNAMARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "227285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02377888",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.