Individual provider Active NPI

Anna Ahn, M.D.

  • Internal Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1700105533
Registry record updated Aug 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D75970 Issued in MD
Practice address
Medical Staff Office T9
Stony Brook University Hospital
Stony Brook, NY 11794
Phone
(631) 444-2754
Fax
(631) 444-6031
NPI assigned
May 18, 2010
Last updated
Aug 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 249976 NY
Internal Medicine Physician 207R00000X D75970 MD Primary

Addresses

Primary practice location

Medical Staff Office T9
Stony Brook University Hospital
Stony Brook, NY 11794

Mailing address

920 Elkridge Landing Rd
Linthicum, MD 21090-2917
Phone (443) 462-5010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20130925000141 MD Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7012151467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
New York Medical College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Brown St
Chestertown, MD 21620-1435

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

2540 Centreville Rd
Centreville, MD 21617-2681
Phone (410) 822-1000

500 Cadmus LN
Easton, MD 21601-4094

713 Cambridge Marketplace Blvd
Cambridge, MD 21613-2563

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249976NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Jul 10, 2013 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jul 10, 2013 Accepting new patients
Shore Health System, Inc CurrentSince Aug 31, 2021 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

500 Cadmus Ln
Ste 209
Easton, MD 21601
Phone (410) 820-4434

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

920 Elkridge Landing Rd
Linthicum Heights, MD 21090

Interoperability endpoints

  • Direct secure messaging: aahn451312@direct.umm.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534032000000",
    "number": "1700105533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ELKRIDGE LANDING RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902917",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL STAFF OFFICE T9",
            "address_2": "STONY BROOK UNIVERSITY HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2754",
            "fax_number": "631-444-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2018-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "249976",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D75970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.