Active NPI
Patricia S Nnaetuk, AHNP
- Adult Health Nurse Practitioner
- Bronx, NY
National Provider Identifier
1144544222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F305133
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231114000288 | NY | Order and Referring Only - Family Practice | 9436348067 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F305133 | NY | MD | Adult Health Nurse Practitioner |
| 337421 | NY | MD | Family Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New 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
- pnnaetuk839969@nychhc.direct-ci.com
- 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.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.