Jeannine Assogba, FNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

405118 Issued in NY

Practice address

3424 Kossuth Ave # 11a-19
Bronx, NY 10467-2410

Phone

(718) 519-3412

NPI assigned

Jul 20, 2017

Last updated

May 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jassogba76480@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  dba Gouverneur Healthcare Services

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  dba Gouverneur Healthcare Services

  • Skilled Nursing Facility
  • New York, NY
  • NPI 1497859573
  NPD
• New York City Health and Hospitals Corporation

  dba Henry J. Carter Specialty Hospital

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1376066415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE FL 11A-19",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672410",
            "telephone_number": "718-519-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE # 11A-19",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672410",
            "telephone_number": "718-519-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSOGBA",
        "first_name": "JEANNINE",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340611",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Associates for Women's Care, LLP
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• Assurance Medical Supply Plus Inc
• Assure Anesthesia, PLLC
• Cynthia Astacio
• Wiglishai Astacio, MS, CF, SLP
• Asthma Intervention and Relief Network Inc

• Psychiatric/Mental Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.