Individual provider Active NPI

Akshay Ganju, M.D.

  • General Practice Physician
  • New York, NY
National Provider Identifier
1083032056
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
288709-1 Issued in NY
Practice address
45 W 67TH St
New York, NY 10023-6257
Phone
(212) 772-9222
Fax
(212) 879-7235
NPI assigned
Apr 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 288709-1 NY Primary

Addresses

Primary practice location

45 W 67TH St
New York, NY 10023-6257

Mailing address

45 W 67TH St
New York, NY 10023-6257

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
I20170619001085 NY Practitioner - Emergency Medicine 2860795770 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288709-1NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akshay Ganju MD-PC General Practice Current Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Emergency Medical Association Sound Shore PLLC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGDHCD/Endpoint/EGDHCD

Organizations & group practices 3

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1083032056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W 67TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 67TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236257",
            "telephone_number": "212-772-9222",
            "fax_number": "212-879-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANJU",
        "first_name": "AKSHAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "288709-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.