NPIMap

Individual provider Active NPI

Marie Iyayomwangbe Omorogbe, FNP-BC

  • Family Nurse Practitioner
  • Albany, NY
National Provider Identifier
1508431784
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344711 Issued in NY
Practice address
2 Palisades Drive
Albany Associates in Cardiology
Albany, NY 12205-1438
Phone
(518) 456-2000
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 344711 NY
Family Nurse Practitioner 363LF0000X F344711-01 NY
Family Nurse Practitioner 363LF0000X 344711 NY Primary

Addresses

Primary practice location

2 Palisades Drive
Albany Associates in Cardiology
Albany, NY 12205-1438

Mailing address

PO Box 14890
Albany, NY 12212-4890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210616002927 NY Practitioner - Nurse Practitioner 6305246034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Palisades Dr
Albany, NY 12205-1438
Phone (518) 458-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F344711-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Nurse Practitioner CurrentSince Jul 25, 2021 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Nurse Practitioner Past Accepting new patients

Locations

63 Shaker Rd
Ste 201
Albany, NY 12204
Phone (518) 446-1850

2 Palisades Dr
Albany, NY 12205

156 Quaker Rd
Queensbury, NY 12804
Phone (518) 793-9063

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: momorogbe834972@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1508431784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PALISADES DRIVE",
            "address_2": "ALBANY ASSOCIATES IN CARDIOLOGY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051438",
            "telephone_number": "518-456-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOROGBE",
        "first_name": "MARIE",
        "middle_name": "IYAYOMWANGBE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "344711",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344711-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.