Individual provider Active NPI

Nana Yaa Agyeiwaa Anokwaa Ampaw, MBCHB

  • Pulmonary Disease Physician
  • Philadelphia, PA
National Provider Identifier
1265165237
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MT233240 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5189
Phone
(800) 836-7536
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125079798 IL
Pulmonary Disease Physician 207RP1001X MT233240 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Mailing address

1922 W Ogden Ave Unit 1616
Chicago, IL 60612-5586
Phone (443) 613-9094

Other practice location 1

1969 W Ogden Ave
Chicago, IL 60612-3765
Phone (443) 613-9094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220817001579 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0446633895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT233240PAMDPulmonary Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1265165237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 W OGDEN AVE UNIT 1616",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606125586",
            "telephone_number": "443-613-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "800-836-7536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1969 W Ogden Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123765",
            "country_code": "US",
            "telephone_number": "443-613-9094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMPAW",
        "first_name": "NANA YAA",
        "middle_name": "AGYEIWAA ANOKWAA",
        "name_prefix": "Dr.",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125079798",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MT233240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.