Individual provider Active NPI

Anila Krovvidi, MD

  • Pediatrics Physician
  • Middletown, NY
National Provider Identifier
1932761210
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
317621 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-7575
Fax
(845) 333-4696
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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 317621 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akrovvidi68769@direct.garnethealth.org Direct Garnet Health Doctors PC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220630000694 NY Practitioner - Pediatric Medicine 7810377330 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317621NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC Pediatrics CurrentSince Dec 1, 2022 Accepting new patients
Vassar Brothers Hospital Past Accepting new patients

Locations

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Interoperability endpoints

  • Direct secure messaging: akrovvidi68769@direct.garnethealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1932761210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROVVIDI",
        "first_name": "ANILA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "317621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akrovvidi68769@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.