Fosua Agyenim Boateng, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

405667 Issued in NY

Practice address

6 Gramatan Ave Ste 606
Mount Vernon, NY 10550-3208

Phone

(212) 961-7299

NPI assigned

Feb 19, 2024

Last updated

Feb 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Tri-Star Behavioral Health Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, NY
  • NPI 1639655293
  Medicare reassignment NPD

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1013772128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HOOVER RD APT 2",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107103440",
            "telephone_number": "914-536-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GRAMATAN AVE STE 606",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503208",
            "telephone_number": "212-961-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGYENIM BOATENG",
        "first_name": "FOSUA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis O. Agbonkpolo, M.D.
• Guirlaine Lenore Agnant, MD
• Ana Aguilar
• Gifty Agyemang, NP-C
• Victoria Agyemang
• Nabeela Ahmed, PHARMD
• Sangeeta Ahuja, RD
• Gladys E Aideyan, FNP
• Paula Aikens-Bennett
• Mir Akbar

• Psychiatric/Mental Health Nurse Practitioner in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.