Ida K Etah, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F336219 Issued in NY

Practice address

2960 Mickle Ave
Bronx, NY 10469-3304

Phone

(646) 683-1949

NPI assigned

Apr 13, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Symphony Medical PCGroup PAC ID 5890916068, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208
• St Joseph'S Medical Center Hospital, Yonkers, NY, CCN 330006
• Harlem Hospital Center Hospital, New York, NY, CCN 330240

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

• FHIR API: https://api.platform.athenahealth.com/23390/brand/1/csg/1/fhir/r4

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.

• Symphony Medical PC

  • Hospitalist Physician
  • Dobbs Ferry, NY
  • NPI 1659787653
  Medicare reassignment Care Compare group NPD
• Symphony Medical PC

  • Orthopaedic Surgery Physician
  • Dobbs Ferry, NY
  • NPI 1023600327
  NPD
• Symphony Medical PC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Yonkers, NY
  • NPI 1043735137
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • New York, NY
  • NPI 1033124961
  Care Compare affiliation
• St Josephs Hospital Yonkers

  • General Acute Care Hospital
  • Harrison, NY
  • NPI 1679883037
  Care Compare affiliation
• St. John'S Riverside Hospital

  • General Acute Care Hospital
  • Yonkers, NY
  • NPI 1578526695
  Care Compare affiliation
• St. Joseph'S Hospital, Yonkers

  • General Acute Care Hospital
  • Yonkers, NY
  • NPI 1477640258
  Care Compare affiliation
• St.Vincent'S Hospital Westchester

  • Case Management Agency
  • Harrison, NY
  • NPI 1760792139

  Hospital

  Care Compare affiliation
• St.Vincent'S Hospital Westchester

  • Adult Mental Health Clinic/Center
  • Harrison, NY
  • NPI 1932419306

  Hospital

  Care Compare affiliation
• St.Vincents Hospital Westchester

  • Adult Mental Health Clinic/Center
  • Harrison, NY
  • NPI 1578873949

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1497045371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 MICKLE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693304",
            "telephone_number": "646-683-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 MICKLE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693304",
            "telephone_number": "646-683-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETAH",
        "first_name": "IDA",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Israel Estrellado, NP
• Mark Christian Manansala Estrellado, M.D.
• Robert Estren
• Robert Anthony Esty
• Vivienne Esty
• Etba Pharmacy Inc.
• Flora Eteng
• Yakini Etheridge, PH.D.
• Brittanie J Etienne, PA-C
• Dominique E Etienne

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.

Verify at the official NPI Registry.