Individual provider Active NPI

Anna Vinokur, D.O.

  • Pediatrics Physician
  • Pompton Plains, NJ
National Provider Identifier
1841345907
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MB77283 Issued in NJ
Practice address
97 W Parkway
Pompton Plains, NJ 07444-1647
Phone
(973) 831-5120
Fax
(973) 831-5342
NPI assigned
Jan 25, 2007
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
Pediatrics Physician 208000000X MB77283 NJ Primary

Addresses

Primary practice location

97 W Parkway
Pompton Plains, NJ 07444-1647

Mailing address

13-24 Sperber Rd # 4C
Fair Lawn, NJ 07410-7343
Phone (201) 796-0675

Other identifiers 1

IdentifierTypeStateIssuer
203BP02004OtherNJTAXONOMY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150929001210 NJ Practitioner - Pediatric Medicine 9931417789 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB77283NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
House Physician Partners, PC CurrentSince Nov 1, 2015 Accepting new patients
Emergency Physician Services of New Jersey,Professional Association CurrentSince Aug 1, 2015 Accepting new patients
Holy Name Medical Center Inc. Past Accepting new patients

Locations

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841345907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13-24 SPERBER RD # 4C",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074107343",
            "telephone_number": "201-796-0675",
            "fax_number": "973-831-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 W PARKWAY",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441647",
            "telephone_number": "973-831-5120",
            "fax_number": "973-831-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINOKUR",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MB77283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "203BP02004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

Verify at the official NPI Registry.