Active NPI
Owen Washington Edwards Jr., MD
- Registered Nurse
- Brooklyn, NY
National Provider Identifier
1154178796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 594922-01
- Practice address
- 450 Clarkson Ave # 67
Brooklyn, NY 11203-2012 - Phone
- (718) 270-1000
- NPI assigned
- May 1, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NY | ||
| Registered Nurse | 163W00000X | 594922-01 | NY | Primary |
Addresses
Primary practice location
450 Clarkson Ave # 67
Brooklyn, NY 11203-2012
Mailing address
463 Boyle Rd # 463
Selden, NY 11784-1237
Phone (631) 747-2935
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20250811000795 | GA | Order and Referring Only - Orthopedic Surgery | 7911405808 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 594922-01 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745798400000",
"number": "1154178796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "463 BOYLE RD # 463",
"city": "SELDEN",
"state": "NY",
"postal_code": "117841237",
"telephone_number": "631-747-2935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 CLARKSON AVE # 67",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032012",
"telephone_number": "718-270-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "OWEN",
"middle_name": "WASHINGTON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-01",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "594922-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.