Nkenna Nkemakolam, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F337122-1 Issued in NY

Practice address

2460 Hylan Blvd
Staten Island, NY 10306-3117

Phone

(718) 226-5619

Fax

(718) 226-5620

NPI assigned

Mar 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: nnkemakolam60810@northwell.direct-ci.com

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Physicians of University Hospital, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Staten Island, NY
  • NPI 1417901323
  Medicare reassignment NPD
• Physicians of University Hospital, PC

  • Anesthesiology Physician
  • Bay Shore, NY
  • NPI 1023513116
  NPD

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1215202650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SHERMAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012333",
            "telephone_number": "347-248-7160",
            "fax_number": "347-248-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063117",
            "telephone_number": "718-226-5619",
            "fax_number": "718-226-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKEMAKOLAM",
        "first_name": "NKENNA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "504531",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337122-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NJM, Inc Dba Mid Island Car Service
• Crystal Njoku, MD
• Stella N Njoku, LPN
• NK Family Health NP PC
• Nkanga Nkanga, M.D.
• Lathifa Mady Nnap, MD
• No Shame Counseling & Consulting Services LLC
• No Tears Dental PC (State Family Dental Care PC)
• Ishak Nobel, MD
• Miguel F Noble Jr., OTR/L

• Family Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.

Verify at the official NPI Registry.