Individual provider Active NPI

Dominica Uduba, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1033641485
Registry record updated Nov 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341022 Issued in NY
Practice address
1072 Grand Concourse
Bronx, NY 10456-3901
Phone
(718) 734-0000
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341022 NY Primary

Addresses

Primary practice location

1072 Grand Concourse
Bronx, NY 10456-3901

Mailing address

PO Box 286500
New York, NY 10128-0005

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
I20170630000603 NY Practitioner - Nurse Practitioner 8921376872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 Gerard Ave
Bronx, NY 10452-8015
Phone (718) 960-2780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
341022NYMDLicensed Practical Nurse
F341022NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Feb 1, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Feb 1, 2021 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

1225 Gerard Ave
Bronx, NY 10452
Phone (718) 960-2777

1012 E Gun Hill Rd
Bronx, NY 10469
Phone (718) 918-8850

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: duduba847911@nychhc.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.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1033641485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 286500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563901",
            "telephone_number": "718-734-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDUBA",
        "first_name": "DOMINICA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.