Individual provider Active NPI

Anita Venkatesan, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1821619255
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
325139 Issued in NY
Practice address
10 Union SQ E
New York, NY 10003-3314
Phone
(212) 844-8100
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 325139 NY Primary

Addresses

Primary practice location

10 Union SQ E
New York, NY 10003-3314

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

6 Healthy Way
Ellenville, NY 12428-5612
Phone (845) 647-4500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001086 NY Practitioner - Family Practice 1850839366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Union SQ E
New York, NY 10003-3314
Phone (212) 844-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1821619255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-844-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Ellenville",
            "state": "NY",
            "postal_code": "124285612",
            "country_code": "US",
            "telephone_number": "845-647-4500",
            "fax_number": "845-647-7632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENKATESAN",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "325139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.