Individual provider Active NPI

Enyioma Nwankpa, MD

  • Obstetrics & Gynecology Physician
  • Mount Vernon, NY
National Provider Identifier
1053522326
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2452701 Issued in NY
Practice address
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone
(914) 699-7200
Fax
(914) 699-0837
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 245270-1 NY
Obstetrics & Gynecology Physician 207V00000X 2452701 NY Primary

Addresses

Primary practice location

107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550

Mailing address

107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone (914) 699-7200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080807000107 NY Practitioner - Obstetrics/Gynecology 8123192259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
245270-1NYMDObstetrics & Gynecology Physician
2452701NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harlem Medical Associates PC CurrentSince Sep 12, 2012 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: enwankpa680236@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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1053522326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWANKPA",
        "first_name": "ENYIOMA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "245270-1",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "2452701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.