Individual provider Active NPI

Charity Enwere

  • Adult Health Nurse Practitioner
  • Saint Albans, NY
National Provider Identifier
1073990073
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
307765 Issued in NY
Practice address
18719 Linden Blvd
Saint Albans, NY 11412-4025
Phone
(718) 276-1100
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 558563 NY
Adult Health Nurse Practitioner 363LA2200X 307765 NY Primary

Addresses

Primary practice location

18719 Linden Blvd
Saint Albans, NY 11412-4025

Mailing address

938 Derrick Adkins LN
West Hempstead, NY 11552-3914
Phone (646) 645-5440

Other practice location 1

91-31 Queens Blvd
Elmhurst, NY 11373
Phone (718) 606-7231

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
I20200302002332 NY Practitioner - Nurse Practitioner 6406283597 Reassigns benefits to 2 organizations

Care Compare profile

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

Practice addresses (Care Compare)

18719 Linden Blvd
Saint Albans, NY 11412-4025
Phone (646) 645-5440

Hospital & facility affiliations

  • Queens Hospital Center Hospital, Jamaica, NY, CCN 330231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
558563NYMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ilm Medical Care PLLC CurrentSince Jul 24, 2023 Accepting new patients

Locations

600 E Crescent Ave
Ste 305
Upper Saddle River, NJ 07458

2975 Independence Ave
Bronx, NY 10463
Phone (718) 542-1700

Networks

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

Interoperability endpoints

  • Direct secure messaging: cenwere359491@nychhc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1073990073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 DERRICK ADKINS LN",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523914",
            "telephone_number": "646-645-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18719 LINDEN BLVD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114124025",
            "telephone_number": "718-276-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91-31 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "11373",
            "country_code": "US",
            "telephone_number": "718-606-7231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENWERE",
        "first_name": "CHARITY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "558563",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, NY

Sources for this page

Verify at the official NPI Registry.