Individual provider Active NPI

Nancilyma Aidoo, FNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1225641129
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012429 Issued in DE
Practice address
1200 Webster Ave
Bronx, NY 10456-4208
Phone
(646) 612-7938
Fax
(646) 839-3915
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0072231 DE
Nurse Practitioner 363L00000X LG-0012429 DE
Family Nurse Practitioner 363LF0000X R248932 MD
Family Nurse Practitioner 363LF0000X LG-0012429 DE Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X F346286-01 NY

Addresses

Primary practice location

1200 Webster Ave
Bronx, NY 10456-4208

Mailing address

1200 Webster Ave
Bronx, NY 10456-4208

Other practice location 1

200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 273-1701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MD, DE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211222001740 NY Practitioner - Nurse Practitioner 9830580091 Reassigns benefits to 2 organizations
I20230817000638 MD Practitioner - Nurse Practitioner 9830580091 Reassigns benefits to 1 organization
I20230817001721 DE Practitioner - Nurse Practitioner 9830580091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Cerebral Palsy of New York City, Inc.Group PAC ID 4688748320, 11 clinicians
Christiana Care Quality PartnersGroup PAC ID 0143657247, 96 clinicians

Practice addresses (Care Compare)

175 Lawrence Ave
Brooklyn, NY 11230-1102
Phone (718) 436-7600

200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 273-1701

310 E Pulaski Hwy
Christianacare Gohealth Urge
Elkton, MD 21921-6435
Phone (443) 485-6213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0072231DEMDRegistered Nurse
LG-0012429DEMDFamily Nurse Practitioner
R248932MDMDFamily Nurse Practitioner
F346286-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divinity Medical Services PLLC Single Specialty CurrentSince Sep 17, 2021 Accepting new patients
Christiana Care Quality Partners Single Specialty CurrentSince Aug 10, 2022 Accepting new patients
Medical Care at Home PC Single Specialty CurrentSince Aug 29, 2024 Accepting new patients
Christiana Care Quality Partners PastSince Aug 1, 2021 Accepting new patients

Locations

1011 E Songsmith Dr
Bear, DE 19701
Phone (302) 918-7501

200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701

4724 Limestone Rd
Wilmington, DE 19808
Phone (302) 467-3595

5555 Glenridge Connector
Ste 700
Sandy Springs, GA 30342
Phone (470) 567-7780

310 E Pulaski Hwy
Elkton, MD 21921
Phone (443) 485-6213

101 North East Plz
North East, MD 21901
Phone (410) 543-2020

1210 Webster Ave
Bronx, NY 10456
Phone (646) 612-7747

220 E 42nd St
Fl 6
New York, NY 10017
Phone (212) 609-9640

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

5065 Wooster Rd
Cincinnati, OH 45226

Interoperability endpoints

  • Direct secure messaging: nancilyma.aidoo@ghuccc.eclinicaldirectplus.com
  • Direct secure messaging: nancilyma.aidoo.1@30409.direct.athenahealth.com

Organizations & group practices 5

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": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1225641129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564208",
            "telephone_number": "646-612-7938",
            "fax_number": "646-839-3915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hygeia Dr",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132049",
            "country_code": "US",
            "telephone_number": "302-273-1701",
            "fax_number": "302-273-4497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AIDOO",
        "first_name": "NANCILYMA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0072231",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0012429",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R248932",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012429",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346286-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.