Individual provider Active NPI

Anika Mannan

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1205709730
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1200 Waters PL
Bronx, NY 10461-2728
Phone
(719) 631-2407
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X NY Primary

Addresses

Primary practice location

1200 Waters PL
Bronx, NY 10461-2728

Mailing address

1200 Waters PL
Bronx, NY 10461-2728
Phone (719) 631-2407

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
I20260407001548 NY Practitioner - Physician Assistant 8527533660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

220 Front St
New York, NY 10038-2033
Phone (212) 385-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1205709730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612728",
            "telephone_number": "719-631-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612728",
            "telephone_number": "719-631-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNAN",
        "first_name": "ANIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.