Individual provider Active NPI

Annmarie Andersen

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1831652874
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310823 Issued in NY
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(212) 241-6500
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 615307 NY
Adult Health Nurse Practitioner 363LA2200X F310823 NY Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

1468 Madison Ave
New York, NY 10029-6508
Phone (212) 241-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601001110 NY Practitioner - Nurse Practitioner 9830556166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
615307NYMDRegistered Nurse
F310823NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1831652874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "ANNMARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "615307",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.