Active NPI
Tracy Owusu, FNP-BC
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1417711706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 635410-1
- Practice address
- 1320 York Ave
New York, NY 10021-4800 - Phone
- (917) 353-6149
- NPI assigned
- Feb 8, 2024
- Last updated
- Feb 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 635410-1 | NY | Primary |
| Family Nurse Practitioner | 363LF0000X | 353718 | NY |
Addresses
Primary practice location
1320 York Ave
New York, NY 10021-4800
Mailing address
1320 York Ave
New York, NY 10021-4800
Phone (917) 353-6149
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1480 E Ave
Bronx, NY 10462-7502
Phone (973) 713-8623
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 353718 | NY | MD | Family Nurse Practitioner |
| 635410-1 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Starling Diagnostics LLC | Current | Accepting new patients | |
| California Medical Imaging Associates, Inc | Past | Accepting new patients |
Locations
1480 East Ave
Bronx, NY 10462
Phone (718) 319-1610
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHGFCD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Bronx, NY
- NPI 1497397152
-
- Diagnostic Radiology Physician
- Visalia, CA
- NPI 1821234899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708819200000",
"number": "1417711706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 YORK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214800",
"telephone_number": "917-353-6149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 YORK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214800",
"telephone_number": "917-353-6149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWUSU",
"first_name": "TRACY",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-08",
"last_updated": "2024-02-25",
"certification_date": "2024-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "635410-1",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "353718",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.