Individual provider Active NPI

Susan Chukwuchebeanyi Uyanna, MD

  • Child & Adolescent Psychiatry Physician
  • Albany, NY
National Provider Identifier
1265782536
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
265440 Issued in NY
Practice address
3 Computer Dr W Ste 105
Albany, NY 12205-1632
Phone
(518) 818-0001
NPI assigned
Sep 14, 2012
Last updated
Oct 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 265440 NY Primary

Addresses

Primary practice location

3 Computer Dr W Ste 105
Albany, NY 12205-1632

Mailing address

3 Computer Dr W Ste 105
Albany, NY 12205-1632
Phone (518) 818-0001

Other identifiers 1

IdentifierTypeStateIssuer
04464586MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160721001150 NY Practitioner - Psychiatry 3678798360 Practice locations: Albany, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
265440NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parsons Child and Family Center Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1265782536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COMPUTER DR W STE 105",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051632",
            "telephone_number": "518-818-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COMPUTER DR W STE 105",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051632",
            "telephone_number": "518-818-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UYANNA",
        "first_name": "SUSAN",
        "middle_name": "CHUKWUCHEBEANYI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "265440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04464586",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.