Ifeomanneka Susan Uduezue, FNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

402818 Issued in NY

Practice address

1 Chimney Point Dr
Ogdensburg, NY 13669-2291

Phone

(315) 541-2001

NPI assigned

Oct 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Ifeomanneka Susan Ikwukeme Former name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridging Access to Care IncGroup PAC ID 9234313909, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bridging Access to Care, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1548368756
  Medicare reassignment Care Compare group NPD
• Supportive Care Psychiatry of Ny PC

  • Clinical Psychologist
  • Fresh Meadows, NY
  • NPI 1740994433
  Medicare reassignment NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Bridging Access to Care, Inc.

  • Community Health Clinic/Center
  • Brooklyn, NY
  • NPI 1528149341
  NPD
• Nys Office of Mental Health

  • Psychiatric Hospital
  • Ogdensburg, NY
  • NPI 1194889360
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1578039822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692291",
            "telephone_number": "315-541-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Chimney Point Dr",
            "address_purpose": "LOCATION",
            "city": "Ogdensburg",
            "state": "NY",
            "postal_code": "136692291",
            "country_code": "US",
            "telephone_number": "315-395-1260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDUEZUE",
        "first_name": "IFEOMANNEKA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343722",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IFEOMANNEKA",
            "last_name": "IKWUKEME",
            "middle_name": "SUSAN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donna Jo Trimm, LCSW
• Bryanna R Tulip
• Gabrielle L Tulip
• Paula Marie Tulip, LCSW
• Marcie E Turnbull, RN
• United Helpers Care Inc
• United Helpers Care Inc
• United Helpers Care Inc
• United Helpers Care Inc
• United Helpers Care Inc

• Psychiatric/Mental Health Nurse Practitioner in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.