Individual provider Active NPI

Dwayne Maurice Jones, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1518442482
Registry record updated Dec 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402289 Issued in NY
Practice address
163 W 125TH St FL 12
New York, NY 10027-4436
Phone
(212) 961-8731
NPI assigned
Sep 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 402289 NY Primary

Addresses

Primary practice location

163 W 125TH St FL 12
New York, NY 10027-4436

Mailing address

163 W 125TH St FL 12
New York, NY 10027-4436
Phone (212) 961-8700

Other practice location 1

234 E 149th St
Bronx, NY 10451-5504
Phone (718) 579-5000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190117003876 NY Practitioner - Nurse Practitioner 6901142546 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Bronx Medical Associates PC Single Specialty CurrentSince Dec 3, 2018 Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1518442482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 W 125TH ST FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274436",
            "telephone_number": "212-961-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 W 125TH ST FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274436",
            "telephone_number": "212-961-8731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 E 149th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515504",
            "country_code": "US",
            "telephone_number": "718-579-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "DWAYNE",
        "middle_name": "MAURICE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.