Active NPI
Chidinma Chisom Duru, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- New York, NY
National Provider Identifier
1538995998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F406328-01
- Practice address
- 198 E 121St St FL 5
New York, NY 10035-3523 - Phone
- (917) 474-2968
- Fax
- (347) 222-3024
- NPI assigned
- Sep 12, 2024
- Last updated
- Apr 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F406328-01 | NY | Primary |
| Medical-Surgical Registered Nurse | 163WM0705X | 26NR22638700 | NJ | |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 738786-01 | NY |
Addresses
Primary practice location
198 E 121St St FL 5
New York, NY 10035-3523
Mailing address
198 E 121St St FL 5
New York, NY 10035-3523
Phone (917) 474-2968
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250212000976 | NY | Practitioner - Nurse Practitioner | 7618407206 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR22638700 | NJ | MD | Medical-Surgical Registered Nurse |
| 738786-01 | NY | MD | Psychiatric/Mental Health Registered Nurse |
| F406328-01 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation of Tomorrow NP in Psychiatry PLLC | Psychiatric/Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatric/Mental Health Nurse Practitioner
- Brooklyn, NY
- NPI 1770403073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1538995998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 E 121ST ST FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100353523",
"telephone_number": "917-474-2968",
"fax_number": "347-222-3024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 E 121ST ST FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100353523",
"telephone_number": "917-474-2968",
"fax_number": "347-222-3024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURU",
"first_name": "CHIDINMA CHISOM",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-12",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F406328-01",
"primary": true
},
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "NJ",
"license": "26NR22638700",
"primary": false
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "NY",
"license": "738786-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.