Individual provider Active NPI

Gifty Agyemang, NP-C

  • Family Nurse Practitioner
  • Mount Vernon, NY
National Provider Identifier
1265857684
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338110-1 Issued in NY
Practice address
107 W 4TH St
Mount Vernon, NY 10550-4002
Phone
(914) 968-4898
Fax
(914) 968-5496
NPI assigned
Feb 21, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115001241 NY Practitioner - Nurse Practitioner 7618270117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F338110-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Oct 19, 2015 Accepting new patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Oct 19, 2015 Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F338110-1 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

107 W 4TH St
Mount Vernon, NY 10550-4002

Mailing address

107 W 4TH St
Mount Vernon, NY 10550-4002

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 20, 2015.

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1265857684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-968-4898",
            "fax_number": "914-968-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGYEMANG",
        "first_name": "GIFTY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338110-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.