Active NPI
Gladys Amaku Tackie-Yarboi, NP
- Registered Nurse
- Bronx, NY
National Provider Identifier
1568137164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 668628
- Practice address
- 4422 3Rd Ave
Bronx, NY 10457-2545 - Phone
- (718) 960-9000
- NPI assigned
- Aug 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 668628 | NY | Primary |
Addresses
Primary practice location
4422 3Rd Ave
Bronx, NY 10457-2545
Mailing address
4422 3Rd Ave
Bronx, NY 10457-2545
Phone (917) 488-7910
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 668628 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SBH Physicians, PC | Current | Accepting new patients | |
| Mount Vernon Neighborhood Health Center, Inc. | Current | Accepting new patients | |
| SBH Physicians, PC | Current | Accepting new patients | |
| Mount Vernon Neighborhood Health Center Inc | Current | Accepting new patients | |
| Mount Vernon Neighborhood Health Center, Inc. | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917
4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730
107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482
- gtackieyarboi19095@sbhny.direct-ci.net
Organizations & group practices 5
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.
-
- Specialist
- Mount Vernon, NY
- NPI 1295912541
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1740595917
-
- Federally Qualified Health Center (FQHC)
- Yonkers, NY
- NPI 1952550055
-
- Pediatrics Physician
- Bronx, NY
- NPI 1457665937
-
- Federally Qualified Health Center (FQHC)
- Mount Vernon, NY
- NPI 1396736120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1568137164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4422 3RD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104572545",
"telephone_number": "917-488-7910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 3RD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104572545",
"telephone_number": "718-960-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKIE-YARBOI",
"first_name": "GLADYS",
"middle_name": "AMAKU",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-16",
"last_updated": "2025-03-10",
"certification_date": "2025-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "668628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.