Individual provider Active NPI

Anthony Ugbala

  • Case Management Registered Nurse
  • North Baldwin, NY
National Provider Identifier
1457978165
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
656033 Issued in NY
Practice address
450 Baldwin Ave
North Baldwin, NY 11510-2501
Phone
(347) 679-3671
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 656033 NY Primary

Addresses

Primary practice location

450 Baldwin Ave
North Baldwin, NY 11510-2501

Mailing address

450 Baldwin Ave
North Baldwin, NY 11510-2501

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

State licenses

LicenseStateTypeSpecialty
656033NYMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1457978165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BALDWIN AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BALDWIN AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102501",
            "telephone_number": "347-679-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UGBALA",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NY",
            "license": "656033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.