Individual provider Active NPI

Doris Amalu, RN

  • Primary Care Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1376857193
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F346824-01 Issued in NY
Practice address
1052 Anderson Ave
Apt-2C
Bronx, NY 10452-5348
Phone
(718) 671-2100
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F346824-01 NY Primary

Addresses

Primary practice location

1052 Anderson Ave
Apt-2C
Bronx, NY 10452-5348

Mailing address

3302 Bouck Ave
Bronx, NY 10469-2920
Phone (347) 932-2472

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
I20220506000147 NY Practitioner - Nurse Practitioner 9436536745 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
F346824-01NYMDPrimary Care Nurse Practitioner

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Oct 17, 2025 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Oct 17, 2025 Accepting new patients

Locations

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Organizations & group practices 3

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1376857193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 BOUCK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692920",
            "telephone_number": "347-932-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 ANDERSON AVE",
            "address_2": "APT-2C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104525348",
            "telephone_number": "718-671-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMALU",
        "first_name": "DORIS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F346824-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.