Individual provider Active NPI

Anjali Prakash

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1962296590
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
335996 Issued in NY
Practice address
200 Varick St RM 900
New York, NY 10014-4893
Phone
(212) 620-0340
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 335996 NY Primary

Addresses

Primary practice location

200 Varick St RM 900
New York, NY 10014-4893

Mailing address

235 Grand St Apt 4305
Jersey City, NJ 07302-4794
Phone (610) 500-6226

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
I20250513000064 NY Practitioner - Family Practice 0547787624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Project Renewal IncGroup PAC ID 6901798651, 8 clinicians

Practice addresses (Care Compare)

8 E 3Rd St
New York, NY 10003-8908
Phone (212) 533-8400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
335996NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Project Renewal Inc CurrentSince May 19, 2025 Accepting new patients
Project Renewal Inc CurrentSince May 19, 2025 Accepting new patients

Locations

200 Varick St
New York, NY 10014
Phone (212) 620-0340

200 Varick St
Fl 9
New York, NY 10014
Phone (212) 620-0340

200 Varick St
Rm 900
New York, NY 10014
Phone (212) 620-0340

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1962296590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 GRAND ST APT 4305",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024794",
            "telephone_number": "610-500-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VARICK ST RM 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144893",
            "telephone_number": "212-620-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAKASH",
        "first_name": "ANJALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "335996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.