Active NPI
Anna Grigoryan
- Physician Assistant
- Hauppauge, NY
National Provider Identifier
1740836634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 024461-01
- Practice address
- 88 Atlantic PL
Hauppauge, NY 11788-4449 - Phone
- (646) 644-0035
- NPI assigned
- Aug 15, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 024461-01 | Primary | |
| Physician Assistant | 363A00000X |
Addresses
Primary practice location
88 Atlantic PL
Hauppauge, NY 11788-4449
Mailing address
88 Atlantic PL
Hauppauge, NY 11788-4449
Phone (646) 644-0035
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024461 | NY | MD | Psychologist |
Interoperability endpoints
- ang9271@direct.nyp.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1740836634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 ATLANTIC PL",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117884449",
"telephone_number": "646-644-0035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 ATLANTIC PL",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117884449",
"telephone_number": "646-644-0035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGORYAN",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-15",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "024461-01",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.