Organization Active NPI

Elite Adult and Senior Practice Inc

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1497525638
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
ELITE ADULT AND SENIOR PRACTICE INC
Practice address
1420 Bushwick Ave
Brooklyn, NY 11207-1422
Phone
(718) 772-7951
Fax
(718) 808-0043
NPI assigned
Jan 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Authorized official

Name
Obioma OnahNPI 1013363951
Title
Owner
Phone
(347) 393-5187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

1420 Bushwick Ave
Brooklyn, NY 11207-1422

Mailing address

21726 138TH Rd
Springfield Gardens, NY 11413-2608
Phone (347) 393-5187

Other practice location 1

1721 Pitkin Ave
Brooklyn, NY 11212-6603
Phone (718) 772-7951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240202003230 NY Part B Supplier - Clinic/Group Practice 1052754363 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1721 Pitkin Ave
Brooklyn, NY 11212
Phone (718) 772-7951

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744416000000",
    "number": "1497525638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21726 138TH RD",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114132608",
            "telephone_number": "347-393-5187",
            "fax_number": "718-808-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 BUSHWICK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071422",
            "telephone_number": "718-772-7951",
            "fax_number": "718-808-0043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 Pitkin Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112126603",
            "country_code": "US",
            "telephone_number": "718-772-7951",
            "fax_number": "718-808-0043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE ADULT AND SENIOR PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A",
        "authorized_official_last_name": "ONAH",
        "authorized_official_first_name": "OBIOMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-393-5187"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.