Individual provider Active NPI

Johana Maradiaga, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1821657974
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
325251 Issued in NY
Practice address
5616 6TH Ave
Brooklyn, NY 11220-3419
Phone
(718) 439-5440
Fax
(646) 754-7572
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 325251 NY Primary

Addresses

Primary practice location

5616 6TH Ave
Brooklyn, NY 11220-3419

Mailing address

5616 6TH Ave
Brooklyn, NY 11220-3419
Phone (718) 439-5440

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
I20230907000501 NY Practitioner - Internal Medicine 7315301579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325251NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Internal Medicine CurrentSince Aug 28, 2023 Accepting new patients
NYU Langone Hospitals CurrentSince Aug 28, 2023 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

5616 6th Ave
Brooklyn, NY 11220
Phone (718) 439-5440

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Networks

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

Interoperability endpoints

  • Direct secure messaging: jmaradiaga361978@nyumc.direct-ci.com

Organizations & group practices 3

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 7

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1821657974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 6TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203419",
            "telephone_number": "718-439-5440",
            "fax_number": "646-754-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 6TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203419",
            "telephone_number": "718-439-5440",
            "fax_number": "646-754-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARADIAGA",
        "first_name": "JOHANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "325251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.