Individual provider Active NPI

Nonso Ekene Enekwechi, M.D., M.P.H.

  • Child & Adolescent Psychiatry Physician
  • New York, NY
National Provider Identifier
1164735296
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
270020 Issued in NY
Practice address
2920 Broadway FL 8
New York, NY 10027-7164
Phone
(212) 854-2878
NPI assigned
Jul 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 270020 NY Primary

Addresses

Primary practice location

2920 Broadway FL 8
New York, NY 10027-7164

Mailing address

2920 Broadway FL 8
New York, NY 10027-7164

Other practice location 1

7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Phone (718) 264-4500

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
I20160222002722 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 8921303470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
270020NYMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1164735296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 BROADWAY FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 BROADWAY FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277164",
            "telephone_number": "212-854-2878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7403 Commonwealth Blvd",
            "address_purpose": "LOCATION",
            "city": "Bellerose",
            "state": "NY",
            "postal_code": "114261839",
            "country_code": "US",
            "telephone_number": "718-264-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENEKWECHI",
        "first_name": "NONSO",
        "middle_name": "EKENE",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "270020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.