Individual provider Active NPI

Anna Michelle Sanders, FNP-BC

  • Family Nurse Practitioner
  • Hewlett, NY
National Provider Identifier
1962917500
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
348630 Issued in NY
Practice address
1571 Broadway
Hewlett, NY 11557-1428
Phone
(516) 295-3003
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
Yes

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 348630 NY Primary
Registered Nurse 163W00000X 720662 NY

Addresses

Primary practice location

1571 Broadway
Hewlett, NY 11557-1428

Mailing address

1571 Broadway
Brooklyn, NY 11207-3396
Phone (516) 295-3003

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260128001347 NY Order and Referring Only - Nurse Practitioner 9133568207

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York Downstate Medical Center, 2021
Medicare assignment
May accept Medicare assignment
Group practices
L'Refuah Medical and Rehabilitation Center, Inc.Group PAC ID 8628068731, shared by 4 NPIs, 17 clinicians

Practice addresses (Care Compare)

3710 13TH Ave
Brooklyn, NY 11218-3602
Phone (718) 686-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
720662NYMDRegistered Nurse
348630NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
L'Refuah Medical & Rehabilitation Center, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michelle.sanders.p1@direct.ezramedical.nextgenshare.com

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": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1962917500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112073396",
            "telephone_number": "516-295-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571428",
            "telephone_number": "516-295-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "ANNA",
        "middle_name": "MICHELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "348630",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "720662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

Verify at the official NPI Registry.