Individual provider Active NPI

Ana Liza Pinga Javier, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1942068630
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R167189 Issued in MD
Practice address
1020 Rutland Ave
Baltimore, MD 21205-2100
Phone
(443) 600-1435
NPI assigned
Mar 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X R167189 MD Primary

Addresses

Primary practice location

1020 Rutland Ave
Baltimore, MD 21205-2100

Mailing address

1728 E Eager St
Baltimore, MD 21205-1112
Phone (443) 600-1435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240708001000 MD Practitioner - Nurse Practitioner 9537603105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R167189MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charm City Healthcare, L.L.C. Single Specialty CurrentSince Jul 22, 2024 Accepting new patients

Locations

223 Eastern Blvd
Essex, MD 21221
Phone (410) 284-2400

120 Eastern Blvd
Ste 122
Essex, MD 21221
Phone (410) 687-8818

Interoperability endpoints

  • Direct secure messaging: ajavier58877@direct.hopkinsmedicine.org

Organizations & group practices 1

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": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1942068630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 E EAGER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051112",
            "telephone_number": "443-600-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 RUTLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052100",
            "telephone_number": "443-600-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIER",
        "first_name": "ANA LIZA",
        "middle_name": "PINGA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R167189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.