Individual provider Active NPI

Juliana N Anyanwu, M.D., M.P.H.

  • Pediatrics Physician
  • Quincy, MA
National Provider Identifier
1790075836
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
281872 Issued in MA
Practice address
859 Willard St Ste 400
Quincy, MA 02169-7469
Phone
(984) 400-0835
Fax
(984) 468-5305
NPI assigned
Apr 11, 2011
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 281872 MA Primary

Addresses

Primary practice location

859 Willard St Ste 400
Quincy, MA 02169-7469

Mailing address

859 Willard St Ste 400
Quincy, MA 02169-7469
Phone (984) 400-0835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200316001703 MA Practitioner - Pediatric Medicine 7315231784 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281872MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Jan 29, 2020 Accepting new patients
Cambridge Public Health Commission CurrentSince Jan 29, 2020 Accepting new patients
Cortica Developmental Therapies PA Past Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

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.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1790075836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST STE 400",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697469",
            "telephone_number": "984-400-0835",
            "fax_number": "984-468-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST STE 400",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697469",
            "telephone_number": "984-400-0835",
            "fax_number": "984-468-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "JULIANA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "281872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.