Individual provider Active NPI

Anna Marie Porizkova, CNM

  • Advanced Practice Midwife
  • Long Island City, NY
National Provider Identifier
1992898639
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000354 Issued in NY
Practice address
3611 21St St
Long Island City, NY 11106-4705
Phone
(718) 482-7772
Fax
(718) 482-4698
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F000354 NY Primary

Addresses

Primary practice location

3611 21St St
Long Island City, NY 11106-4705

Mailing address

69 Glen Rd
F3
Eastchester, NY 10709-3121
Phone (914) 330-5788

Other identifiers 2

IdentifierTypeStateIssuer
00246075MedicaidNY
00695941MedicaidNY

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000354NYMDPhysician Assistant
F000354NYMDAdvanced Practice Midwife

Interoperability endpoints

  • Direct secure messaging: anna.porizkova@chn.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1992898639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 GLEN RD",
            "address_2": "F3",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107093121",
            "telephone_number": "914-330-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 21ST ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064705",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORIZKOVA",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.