Individual provider Active NPI

Esther Makanjuola, CRNP - PEDIATRICS

  • Pediatric Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1609276302
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R209190 Issued in MD
Practice address
5900 Waterloo Rd
Suite 224
Columbia, MD 21045-2630
Phone
(667) 214-2001
NPI assigned
Aug 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R209190 MD Primary

Addresses

Primary practice location

5900 Waterloo Rd
Suite 224
Columbia, MD 21045-2630

Mailing address

5900 Water
5900 Waterloo Road
Columbia, MD 21045
Phone (667) 214-2001

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
I20200720002149 NY Practitioner - Nurse Practitioner 1355765645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

3360 Route 343
Amenia, NY 12501-5619
Phone (845) 838-7038

82 Middle Country Rd
Coram, NY 11727-4411
Phone (631) 320-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R209190MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince May 18, 2020 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: esther.makanjuola@hrh.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1609276302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 WATER",
            "address_2": "5900 WATERLOO ROAD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "667-214-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO RD",
            "address_2": "SUITE 224",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452630",
            "telephone_number": "667-214-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKANJUOLA",
        "first_name": "ESTHER",
        "name_prefix": "Ms.",
        "credential": "CRNP - PEDIATRICS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R209190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.