Individual provider Active NPI

Nnenna Onuoha-Jackson

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1033837513
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353995 Issued in NY
Practice address
1826 White Plains Rd Apt 1E
Bronx, NY 10462-1429
Phone
(191) 477-5905
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 353995 NY Primary

Addresses

Primary practice location

1826 White Plains Rd Apt 1E
Bronx, NY 10462-1429

Mailing address

630 W 170TH St
New York, NY 10032-3512

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
I20240531000554 NY Practitioner - Nurse Practitioner 0941642250 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

1826 White Plains Rd
Apt 1E
Bronx, NY 10462-1429
Phone (877) 258-6331

50 Sheffield Ave
Brooklyn, NY 11207-2420
Phone (718) 345-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
353995NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nko Nurse Practitioner in Family Health PLLC CurrentSince Feb 4, 2025 Accepting new patients
JDS Medical Services PC CurrentSince Dec 9, 2025 Accepting new patients
Medical Director Services PC CurrentSince Apr 22, 2024 Accepting new patients

Locations

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

228 E Route 59
Nanuet, NY 10954
Phone (718) 280-5436

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1033837513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 170TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 WHITE PLAINS RD APT 1E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621429",
            "telephone_number": "191-477-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONUOHA-JACKSON",
        "first_name": "NNENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.