Active NPI
Johanna Deossa, MD
- Physician Assistant
- New York, NY
National Provider Identifier
1669078440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000067-P.A.
- Practice address
- 116 E 36TH St
New York, NY 10016-3402 - Phone
- (212) 686-6329
- NPI assigned
- Dec 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000067-P.A. | PR | Primary |
Addresses
Primary practice location
116 E 36TH St
New York, NY 10016-3402
Mailing address
PO Box 1887
New York, NY 10163-1887
Other names 1
- Dr. Johanna Deossa
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000067-P.A. | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1669078440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1887",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101631887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 E 36TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100163402",
"telephone_number": "212-686-6329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEOSSA",
"first_name": "JOHANNA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-08",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "000067-P.A.",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOHANNA",
"last_name": "DEOSSA",
"prefix": "DR.",
"credential": "PA",
"code": "2",
"type": "Professional Name"
}
]
}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 Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.