Individual provider Active NPI

Emmanuel Ahipue, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1104235092
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402308-01 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2508
Phone
(718) 630-7000
NPI assigned
Aug 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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 F402308-01 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2508

Mailing address

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170329002552 NY Practitioner - Nurse Practitioner 1658695325 Reassigns benefits to 4 organizations
I20251112001098 PA Practitioner - Nurse Practitioner 1658695325 Reassigns benefits to 1 organization
I20251112001970 DC Practitioner - Nurse Practitioner 1658695325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Project Hospitality IncGroup PAC ID 3577884097, 2 clinicians

Practice addresses (Care Compare)

14 Slosson Ter
Staten Island, NY 10301-2507
Phone (718) 273-8409

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F402308-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles (7 of 10)

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Feb 22, 2017 Accepting new patients
Amboy Medical Practice PC CurrentSince Sep 1, 2024 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Oct 10, 2025 Accepting new patients
Agape Life and Health, LLC Family CurrentSince Dec 15, 2024 Accepting new patients
Agape Life Health NP in Psychiatry and Family Health PLLC Psychiatric/Mental Health CurrentSince Dec 20, 2025 Accepting new patients
Enduring Health Care Services LLC Current Accepting new patients
Project Hospitality, Inc. CurrentSince May 22, 2018 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

100 Park Ave
Staten Island, NY 10302
Phone (718) 448-1544

14 Slosson Ter
Staten Island, NY 10301
Phone (718) 273-8409

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Networks

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

Organizations & group practices 7

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1104235092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHIPUE",
        "first_name": "EMMANUEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402308-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.