Individual provider Active NPI

Anne Chmilewski, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1922445485
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A134925 Issued in CA
Practice address
1016 Outer Rd
San Diego, CA 92154-1351
Phone
(619) 429-3733
NPI assigned
May 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A134925 CA Primary

Addresses

Primary practice location

1016 Outer Rd
San Diego, CA 92154-1351

Mailing address

1016 Outer Rd
San Diego, CA 92154-1351
Phone (619) 429-3733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181011002210 TX Practitioner - Family Practice 3577844745 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134925CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Mar 27, 2019 Accepting new patients
Lechee Health Facility Family Medicine CurrentSince Mar 27, 2019 Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine Current Accepting new patients

Locations

3480 E Route 66
Flagstaff, AZ 86004
Phone (928) 438-9985

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": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1922445485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 OUTER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541351",
            "telephone_number": "619-429-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 OUTER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541351",
            "telephone_number": "619-429-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMILEWSKI",
        "first_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A134925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.