Individual provider Active NPI

Bozena Dubaj, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1427696020
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
641874 Issued in NY
Practice address
1775 Grand Concourse FL 8
Bronx, NY 10453-8202
Phone
(212) 665-1860
Fax
(718) 294-4034
NPI assigned
Dec 13, 2019
Last updated
Dec 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 641874 NY Primary

Addresses

Primary practice location

1775 Grand Concourse FL 8
Bronx, NY 10453-8202

Mailing address

1775 Grand Concourse FL 8
Bronx, NY 10453-8202
Phone (212) 665-1860

Other practice location 1

71 W 23rd St Fl 7
New York, NY 10010-4102
Phone (212) 665-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
641874NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Postgraduate Center for Mental Health CurrentSince Dec 15, 2019 Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Dec 15, 2019 Accepting new patients

Locations

1775 Grand Concourse
Fl 8
Bronx, NY 10453
Phone (212) 560-6700

71 W 23rd St
Fl 7
New York, NY 10010
Phone (212) 576-4100

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.

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1427696020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE FL 8",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "212-665-1860",
            "fax_number": "718-294-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE FL 8",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "212-665-1860",
            "fax_number": "718-294-4034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 W 23rd St Fl 7",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104102",
            "country_code": "US",
            "telephone_number": "212-665-1860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBAJ",
        "first_name": "BOZENA",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "641874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.