NPIMap

Organization Active NPI

Obosa Medical Care, P.L.L.C.

  • Specialist
  • Mount Vernon, NY
National Provider Identifier
1194055012
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OBOSA MEDICAL CARE, P.L.L.C.
Practice address
140 Stevens Ave
Mount Vernon, NY 10550-2515
Phone
(914) 530-2323
Fax
(914) 530-2320
NPI assigned
Dec 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Francis Agbonkpolo, M.D.NPI 1467555458
Title
Ceo
Phone
(914) 530-2323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

140 Stevens Ave
Mount Vernon, NY 10550-2515

Mailing address

140 Stevens Ave
Mount Vernon, NY 10550-2515
Phone (914) 530-2323

Other identifiers 1

IdentifierTypeStateIssuer
3585OtherNYAMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.

National Provider Directory

National Provider Directory

Locations

140 Stevens Ave
Mount Vernon, NY 10550
Phone (914) 530-2323

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1194055012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 STEVENS AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502515",
            "telephone_number": "914-530-2323",
            "fax_number": "914-530-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 STEVENS AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502515",
            "telephone_number": "914-530-2323",
            "fax_number": "914-530-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBOSA MEDICAL CARE, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "AGBONKPOLO",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "914-530-2323",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.",
            "identifier": "3585",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.