Active NPI
Anna-Marie Malazarte Veneracion-Yumul, M.D.
- Child & Adolescent Psychiatry Physician
- Orange Park, FL
National Provider Identifier
1710034806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- ME92819
- Practice address
- 1409 Kingsley Ave
Ste 9E
Orange Park, FL 32073-4537 - Phone
- (904) 215-4151
- Fax
- (904) 215-4165
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME92819 | FL | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | ME92819 | FL | Primary |
Addresses
Primary practice location
1409 Kingsley Ave
Ste 9E
Orange Park, FL 32073-4537
Mailing address
1118 Green Pine Cir
Orange Park, FL 32065-2567
Phone (904) 282-8079
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 272990300 | Medicaid | FL | |
| 2600109465852 | Other | FL | TAX ID # |
Other names 1
- Dr. Anna Veneracion Yumul
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121217000373 | FL | Practitioner - Psychiatry | 9436052495 | Practice locations: Orange Park, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1710034806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 GREEN PINE CIR",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320652567",
"telephone_number": "904-282-8079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 KINGSLEY AVE",
"address_2": "STE 9E",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734537",
"telephone_number": "904-215-4151",
"fax_number": "904-215-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENERACION-YUMUL",
"first_name": "ANNA-MARIE",
"middle_name": "MALAZARTE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME92819",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "FL",
"license": "ME92819",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "272990300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "2600109465852",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNA",
"last_name": "YUMUL",
"middle_name": "VENERACION",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.