Individual provider Active NPI

Monica Hyun Ju An, N.P.

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1578019907
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307860 Issued in NY
Practice address
1468 Madison Ave # 1157
New York, NY 10029-6508
Phone
(212) 241-8087
NPI assigned
Aug 26, 2016
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 307860 NY
Adult Health Nurse Practitioner 363LA2200X F307860 NY Primary
Primary Care Nurse Practitioner 363LP2300X 537603 NY

Addresses

Primary practice location

1468 Madison Ave # 1157
New York, NY 10029-6508

Mailing address

600 12TH St Apt 507
Palisades Park, NJ 07650-2083
Phone (347) 301-4575

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
I20170203000170 NY Practitioner - Nurse Practitioner 0749563468 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F307860NYMDAdult Health Nurse Practitioner
537603NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Single Specialty CurrentSince Nov 29, 2016 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Nov 29, 2016 Accepting new patients
Memorial Solid Tumor Group Single Specialty CurrentSince Mar 19, 2018 Accepting new patients
Civic Medicine, PLLC Single Specialty CurrentSince Sep 10, 2023 Accepting new patients
Nyc Medical Infusion PC Single Specialty CurrentSince May 9, 2023 Accepting new patients
Trustees of Columbia University in the City of New York Single Specialty CurrentSince Nov 29, 2016 Accepting new patients
Civic Infusion Westchester, LLC Single Specialty PastSince Dec 9, 2019 Accepting new patients

Locations

249 Danbury Rd
Wilton, CT 06897
Phone (203) 762-3353

1140 Broadway
New York, NY 10001
Phone (516) 941-6824

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

175 E 96th St
New York, NY 10128
Phone (212) 426-1970

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

400 Columbus Ave
Valhalla, NY 10595
Phone (203) 883-0038

400 Columbus Ave
Ste 105S
Valhalla, NY 10595
Phone (203) 883-0038

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1578019907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 12TH ST APT 507",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502083",
            "telephone_number": "347-301-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE # 1157",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AN",
        "first_name": "MONICA",
        "middle_name": "HYUN JU",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307860",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307860",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "537603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.