Individual provider Active NPI

Ama Obenewa

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1023856879
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405661-01 Issued in NY
Practice address
25 Avenue D
New York, NY 10009-6935
Phone
(212) 395-4400
NPI assigned
Jul 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F405661-01 NY Primary

Addresses

Primary practice location

25 Avenue D
New York, NY 10009-6935

Mailing address

20 Burling LN Apt 2K
New Rochelle, NY 10801-5665
Phone (917) 870-5262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F405661-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Educational Alliance, Inc. CurrentSince Sep 14, 2024 Accepting new patients

Locations

197 E Broadway
New York, NY 10002
Phone (212) 780-2300

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/aura_educational_alliance

Organizations & group practices 1

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": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1023856879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BURLING LN APT 2K",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015665",
            "telephone_number": "917-870-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 AVENUE D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100096935",
            "telephone_number": "212-395-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENEWA",
        "first_name": "AMA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405661-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.