Individual provider Active NPI

Judy Amalanathan, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1407813793
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA56990 Issued in NJ
Practice address
800 Poly PL
Medical Service (111)
Brooklyn, NY 11209-7104
Phone
(718) 630-3766
Fax
(718) 630-3761
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA56990 NJ Primary

Addresses

Primary practice location

800 Poly PL
Medical Service (111)
Brooklyn, NY 11209-7104

Mailing address

52 Stafford Ave
Staten Island, NY 10312-2313
Phone (718) 984-8752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA56990NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407813793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122313",
            "telephone_number": "718-984-8752",
            "fax_number": "718-630-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "address_2": "MEDICAL SERVICE (111)",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-630-3766",
            "fax_number": "718-630-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMALANATHAN",
        "first_name": "JUDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA56990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.