Individual provider Active NPI

Patricia S Nnaetuk, AHNP

  • Adult Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1144544222
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305133 Issued in NY
Practice address
1400 Pelham Pkwy S BLDG 1
Jacobi Medical Center
Bronx, NY 10461-1119
Phone
(718) 918-6052
Fax
(718) 918-7701
NPI assigned
Mar 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305133 NY Primary
Family Health Clinical Nurse Specialist 364SF0001X 337421 NY

Addresses

Primary practice location

1400 Pelham Pkwy S BLDG 1
Jacobi Medical Center
Bronx, NY 10461-1119

Mailing address

1400 Pelham Parkway South
Jacobi Medical Center
Bronx, NY 10461
Phone (718) 918-6052

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
I20231114000288 NY Order and Referring Only - Family PracticePractitioner - Family Practice 9436348067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F305133NYMDAdult Health Nurse Practitioner
337421NYMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: pnnaetuk839969@nychhc.direct-ci.com
  • Direct secure messaging: patricia.nnaeuk.1@24989.direct.athenahealth.com

Organizations & group practices 1

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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1144544222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PARKWAY SOUTH",
            "address_2": "JACOBI MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-918-6052",
            "fax_number": "718-918-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S BLDG 1",
            "address_2": "JACOBI MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611119",
            "telephone_number": "718-918-6052",
            "fax_number": "718-918-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNAETUK",
        "first_name": "PATRICIA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "AHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305133",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "NY",
            "license": "337421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.