Individual provider Active NPI

Donna A Annillo, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Teaneck, NJ
National Provider Identifier
1740224377
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
25MD00171900 Issued in NJ
Practice address
933 Garrison Ave
Teaneck, NJ 07666-2653
Phone
(201) 836-0003
Fax
(201) 836-0003
NPI assigned
Jun 15, 2006
Last updated
May 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 25MD00171900 NJ Primary
Sports Medicine Podiatrist 213ES0000X 25MD00171900 NJ
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00171900 NJ
Foot Surgery Podiatrist 213ES0131X 25MD00171900 NJ

Addresses

Primary practice location

933 Garrison Ave
Teaneck, NJ 07666-2653

Mailing address

933 Garrison Avenue
Teaneck, NJ 07666-2653
Phone (201) 836-0003

Other identifiers 1

IdentifierTypeStateIssuer
4826507MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000086 NJ Practitioner - Podiatry 6406016039 Practice locations: Teaneck, NJ; Union City, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 -03 Palisade Ave
Union City, NJ 07087-4121
Phone (201) 863-3338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00171900NJMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: donna.annillo@direct.hobokenumc.md

Organizations & group practices 1

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1740224377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 GARRISON AVENUE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662653",
            "telephone_number": "201-836-0003",
            "fax_number": "201-836-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 GARRISON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662653",
            "telephone_number": "201-836-0003",
            "fax_number": "201-836-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNILLO",
        "first_name": "DONNA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "25MD00171900",
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NJ",
            "license": "25MD00171900",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00171900",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "25MD00171900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4826507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.