Individual provider Active NPI

Olivia Maamle Obuabang, FNP

  • Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1013425768
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F342394-1 Issued in NY
Practice address
12 Knightsbridge Unit E
Poughkeepsie, NY 12603-3641
Phone
(646) 245-9527
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F342394-1 NY Primary

Addresses

Primary practice location

12 Knightsbridge Unit E
Poughkeepsie, NY 12603-3641

Mailing address

12 Knightsbridge Unit E
Poughkeepsie, NY 12603-3641
Phone (646) 245-9527

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190111001426 NY Practitioner - Nurse Practitioner 5698011666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

233 Saratoga Rd
Glenville, NY 12302-4508
Phone (518) 930-7497

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F342394-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 10, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Jun 10, 2020 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Feb 5, 2024 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

111 E 210th St
New York, NY 10261
Phone (718) 920-4799

225 S Cascade Dr
Springville, NY 14141
Phone (716) 599-1163

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1013425768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 KNIGHTSBRIDGE UNIT E",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033641",
            "telephone_number": "646-245-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 KNIGHTSBRIDGE UNIT E",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033641",
            "telephone_number": "646-245-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBUABANG",
        "first_name": "OLIVIA",
        "middle_name": "MAAMLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F342394-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.