Individual provider Active NPI

Charles Edusei

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1215345392
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338710-1 Issued in NY
Practice address
1280 Givan Ave
Gevans Medical Practice
Bronx, NY 10469
Phone
(347) 449-5936
Fax
(347) 449-5937
NPI assigned
Aug 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F338710-1 NY Primary

Addresses

Primary practice location

1280 Givan Ave
Gevans Medical Practice
Bronx, NY 10469

Mailing address

8 Fordham Hill Oval Apt 10G
Bronx, NY 10468-4807
Phone (646) 319-5561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F338710-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gevans Medical Practice P.C PastSince Jun 20, 2010 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1215345392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FORDHAM HILL OVAL APT 10G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104684807",
            "telephone_number": "646-319-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 GIVAN AVE",
            "address_2": "GEVANS MEDICAL PRACTICE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10469",
            "telephone_number": "347-449-5936",
            "fax_number": "347-449-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDUSEI",
        "first_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338710-1",
            "primary": true
        }
    ],
    "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 Aug 1, 2014; 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.