Individual provider Active NPI

Mary Ann Witt, PNP

  • Pediatric Registered Nurse
  • New York, NY
National Provider Identifier
1770672511
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
380687 Issued in NY
Practice address
3959 Broadway
Chony 214N
New York, NY 10032-1559
Phone
(212) 342-8585
Fax
(212) 305-9771
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 380687 NY Primary

Addresses

Primary practice location

3959 Broadway
Chony 214N
New York, NY 10032-1559

Mailing address

3959 Broadway
Chony 214N
New York, NY 10032-1559
Phone (212) 342-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
380687NYMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770672511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "CHONY 214N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-342-8585",
            "fax_number": "212-305-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "CHONY 214N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-342-8585",
            "fax_number": "212-305-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "MARY ANN",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "380687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.