Individual provider Active NPI

Annette Obolevich Nusbaum, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1679539043
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
205573 Issued in NY
Practice address
530 1St Ave
New York, NY 10016-6402
Phone
(212) 263-0050
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA06450800 NJ
Diagnostic Radiology Physician 2085R0202X 205573 NY Primary

Addresses

Primary practice location

530 1St Ave
New York, NY 10016-6402

Mailing address

4 Saddle Hill Rd
Far Hills, NJ 07931-2204

Other identifiers 1

IdentifierTypeStateIssuer
01928129MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anusbaum34972@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050823000135 NJ Practitioner - Diagnostic Radiology 4688605363 Reassigns benefits to 1 organization
I20080326000535 NY Practitioner - Diagnostic Radiology 4688605363 Reassigns benefits to 2 organizations
I20251201000349 FL Practitioner - Diagnostic Radiology 4688605363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers, Robert Woood Johnson Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1300 Ave P
Brooklyn, NY 11229-1106
Phone (718) 376-1004

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

150 E 32ND St
New York, NY 10016-6058
Phone (212) 263-3049

1530 Front St
East Meadow, NY 11554-2265
Phone (516) 324-7500

159 E 53Rd St
New York, NY 10022-4602
Phone (646) 754-3300

16244 S Military TRL
560 NYU Langone Cardiology Delray Bea
Delray Beach, FL 33484-6532
Phone (561) 495-7787

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 538-2000

2318 31St St
Suite 200
Astoria, NY 11105-2765
Phone (718) 777-7742

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

6915 Austin St
Forest Hills, NY 11375-4255
Phone (718) 544-5100

74 Kent St
Brooklyn, NY 11222-1517
Phone (516) 365-4949

77 Medford Ave
Patchogue, NY 11772-1281
Phone (631) 758-1910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 7, 2013 Accepting new patients
New York University Current Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Univ of Penn Community Radiology Diagnostic Radiology Past Accepting new patients
Imaging Consultants of Essex, P.a. Diagnostic Radiology Past Accepting new patients

Locations

95 Madison Ave
Morristown, NJ 07960
Phone (973) 267-1010

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: anusbaum34972@nyumc.direct-ci.com

Organizations & group practices 6

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 9

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1679539043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SADDLE HILL RD",
            "city": "FAR HILLS",
            "state": "NJ",
            "postal_code": "079312204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSBAUM",
        "first_name": "ANNETTE",
        "middle_name": "OBOLEVICH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA06450800",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "205573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01928129",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anusbaum34972@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.