Organization Active NPI

Annadale NP in Family Health P.C.

  • Primary Care Clinic/Center
  • Staten Island, NY
National Provider Identifier
1558232108
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ANNADALE NP IN FAMILY HEALTH P.C.
Practice address
3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414
Phone
(718) 967-1071
NPI assigned
Sep 16, 2025
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Irena Hovhannisyan, FNPNPI 1699520304
Title
FNP
Phone
(646) 406-9286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414

Mailing address

3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251106004257 NY Part B Supplier - Clinic/Group Practice 5698265791 Receives reassigned benefits from 1 practitioner
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Locations

3974 Amboy Rd
Ste 302
Staten Island, NY 10308
Phone (347) 730-4606

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1558232108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3974 AMBOY RD STE 302",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3974 AMBOY RD STE 302",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082414",
            "telephone_number": "718-967-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNADALE NP IN FAMILY HEALTH P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "HOVHANNISYAN",
        "authorized_official_first_name": "IRENA",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "646-406-9286",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.