Individual provider Active NPI

Anju Aniyan Puthanpurayil, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1770146839
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010982 Issued in CA
Practice address
5410 W 61St St
Los Angeles, CA 90056-9005
Phone
(310) 661-1956
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010982 CA Primary

Addresses

Primary practice location

5410 W 61St St
Los Angeles, CA 90056-9005

Mailing address

5410 W 61St St
Los Angeles, CA 90056-2003
Phone (310) 661-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250801000681 CA Order and Referring Only - Nurse Practitioner 4880102870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1770146839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 W 61ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900562003",
            "telephone_number": "310-661-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 W 61ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900569005",
            "telephone_number": "310-661-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHANPURAYIL",
        "first_name": "ANJU",
        "middle_name": "ANIYAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.