Individual provider Active NPI

Ujunwa Okwukaogu

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynn, MA
National Provider Identifier
1316471568
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2292056 Issued in MA
Practice address
118 Franklin Street #3
Lynn, MA 01902
Phone
(781) 363-0058
NPI assigned
Apr 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2292056 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2292056 MA Primary

Addresses

Primary practice location

118 Franklin Street #3
Lynn, MA 01902

Mailing address

328 Broadway Ste 209
Lynn, MA 01904-2654
Phone (781) 363-0058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250903003055 MA Practitioner - Nurse Practitioner 0244501807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

328 Broadway
Suite 209
Lynn, MA 01904-2654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uv Healthcare LLC Psychiatric/Mental Health CurrentSince Aug 15, 2025 Accepting new patients
Progress Healthcare LLC CurrentSince Jun 2, 2017 Accepting new patients

Locations

328 Broadway
Ste 202
Lynn, MA 01904
Phone (781) 363-0058

328 Broadway
Ste 209
Lynn, MA 01904
Phone (781) 363-0058

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Progress Healthcare LLCLynn, MA, CCN 227729 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Director (50%)
W-2 Managing Employee (100%)
Jun 2, 2017
Jun 2, 2017
Jun 2, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1316471568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 BROADWAY STE 209",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042654",
            "telephone_number": "781-363-0058",
            "fax_number": "781-842-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 FRANKLIN STREET #3",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "01902",
            "telephone_number": "781-363-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKWUKAOGU",
        "first_name": "UJUNWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2292056",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2292056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.