Individual provider Active NPI

Anna V Rozentul, D.O.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790978955
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
250561 Issued in NY
Practice address
2175 86TH St
Brooklyn, NY 11214-3205
Phone
(646) 828-6401
Fax
(646) 828-6403
NPI assigned
Aug 21, 2007
Last updated
Jun 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB10058000 NJ
Family Medicine Physician 207Q00000X 250561 NY Primary

Addresses

Primary practice location

2175 86TH St
Brooklyn, NY 11214-3205

Mailing address

135 Sea Breeze Ave Ste 101
Brooklyn, NY 11224-3701
Phone (718) 338-0300

Other practice location 1

135 Sea Breeze Ave
Suite 101
Brooklyn, NY 11224-3700
Phone (718) 338-2957

Other names 1

  • Ms. Anna Smirnov Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address arozentul@direct.practicefusion.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101130000473 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6305032541 Reassigns benefits to 3 organizations
I20171006001579 NJ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6305032541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jun 19, 2020 Accepting new patients
Optum Urgent Care, PLLC Multi-Specialty CurrentSince Dec 6, 2017 Accepting new patients
City Medical of Upper East Side, PLLC Multi-Specialty Current Accepting new patients
Summit Medical Group PA Multi-Specialty CurrentSince Jun 19, 2020 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

4954 Merrick Rd
Massapequa Park, NY 11762
Phone (516) 308-7255

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Interoperability endpoints

  • Direct secure messaging: anna.rozentul.1@2983.direct.athenahealth.com
  • Direct secure messaging: arozentul@direct.practicefusion.com

Organizations & group practices 5

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1790978955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SEA BREEZE AVE STE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243701",
            "telephone_number": "718-338-0300",
            "fax_number": "718-513-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143205",
            "telephone_number": "646-828-6401",
            "fax_number": "646-828-6403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Sea Breeze Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112243700",
            "country_code": "US",
            "telephone_number": "718-338-2957",
            "fax_number": "718-513-0434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROZENTUL",
        "first_name": "ANNA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10058000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "250561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arozentul@direct.practicefusion.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "135 Sea Breeze Ave",
            "address_2": "Suite 101",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112243700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "SMIRNOV",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.