Active NPI
Anne R Duque, MD
- Allergy Physician
- Staten Island, NY
National Provider Identifier
1831290428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 149509
- Practice address
- 1050 Clove Rd
Staten Island, NY 10301-3627 - Phone
- (718) 816-6440
- Fax
- (718) 816-3784
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 149509 | NY | |
| Allergy Physician | 207KA0200X | 149509 | NY | Primary |
Addresses
Primary practice location
1050 Clove Rd
Staten Island, NY 10301-3627
Mailing address
2791 Richmond Ave
Suite 201
Staten Island, NY 10314-5859
Phone (718) 816-6440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01841872 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149509 | NY | MD | Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Nephrology PLLC | Past | Accepting new patients | |
| Richmond University Medical Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Nephrology Physician
- Brooklyn, NY
- NPI 1881802973
-
- Multi-Specialty Clinic/Center
- Staten Island, NY
- NPI 1811054042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378252800000",
"number": "1831290428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2791 RICHMOND AVE",
"address_2": "SUITE 201",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103145859",
"telephone_number": "718-816-6440",
"fax_number": "718-816-3611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 CLOVE RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013627",
"telephone_number": "718-816-6440",
"fax_number": "718-816-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUQUE",
"first_name": "ANNE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2013-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "149509",
"primary": false
},
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "NY",
"license": "149509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01841872",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.