Active NPI
Anannya Shaji Johny
- Family Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 350053
- Practice address
- 622 W 168TH St
New York, NY 10032-3720 - Phone
- (212) 305-4600
- NPI assigned
- Oct 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 350053 | NY | Primary |
| Family Nurse Practitioner | 363LF0000X | 26NJ15087300 | NJ |
Addresses
Primary practice location
622 W 168TH St
New York, NY 10032-3720
Mailing address
622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-4600
Other practice location 1
8 E Grand Ave
Montvale, NJ 07645-2536
Phone (201) 474-5189
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ15087300 | NJ | MD | Family Nurse Practitioner |
| 350053 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| North Shore-Lij Medical Group P.C. | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the Department of Otolaryngology | Past | Accepting new patients |
Locations
600 Community Dr
Ste 400
Manhasset, NY 11030
Phone (516) 600-1100
630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
173 Fort Washington Ave
New York, NY 10032
Phone (212) 305-4600
27005 76th Ave
North New Hyde Pk, NY 11040
300 Community Dr
Plandome, NY 11030
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- gny9005@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 5
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.
-
dba North Shore University Hospital Independence at Home Demonstration
- Internal Medicine Physician
- Manhasset, NY
- NPI 1942666557
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Anesthesiology Physician
- New York, NY
- NPI 1477068971
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
- Specialist
- New York, NY
- NPI 1801074315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757376000000",
"number": "1356066815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-4600"
}
],
"practiceLocations": [
{
"address_1": "8 E Grand Ave",
"address_purpose": "LOCATION",
"city": "Montvale",
"state": "NJ",
"postal_code": "076452536",
"country_code": "US",
"telephone_number": "201-474-5189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNY",
"first_name": "ANANNYA",
"middle_name": "SHAJI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-06",
"last_updated": "2025-09-09",
"certification_date": "2025-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "350053",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ15087300",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.