Active NPI
Anna Henisz, MD
- Diagnostic Radiology Physician
- Farmington, CT
National Provider Identifier
1952307159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 015924
- Practice address
- 263 Farmington Ave
Farmington, CT 06030-0001 - Phone
- (860) 679-2784
- Fax
- (860) 679-4126
- NPI assigned
- Jun 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 015924 | CT | Primary |
Addresses
Primary practice location
263 Farmington Ave
Farmington, CT 06030-0001
Mailing address
65 Kane St
West Hartford, CT 06119-2110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1159243 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015924 | CT | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Connecticut Health Center | Past | Accepting new patients | |
| University of Connecticut Health Center | Diagnostic Radiology | Past | Accepting new patients |
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.
-
- Clinical Medical Laboratory
- Farmington, CT
- NPI 1427031293
-
- General Practice Physician
- Farmington, CT
- NPI 1720083769
Diagnostic Radiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1952307159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 KANE ST",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061192110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060300001",
"telephone_number": "860-679-2784",
"fax_number": "860-679-4126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENISZ",
"first_name": "ANNA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-22",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CT",
"license": "015924",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1159243",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.