Individual provider Active NPI

Samantha Wnukowski

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1619487873
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
681733 Issued in NY
Practice address
1825 Eastchester Rd
Bronx, NY 10461-2301
Phone
(718) 904-4032
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 356524 NY
Registered Nurse 163W00000X 681733 NY Primary

Addresses

Primary practice location

1825 Eastchester Rd
Bronx, NY 10461-2301

Mailing address

186 Baraud Rd N
Scarsdale, NY 10583-6664
Phone (917) 370-0447

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
I20260424002292 NY Practitioner - Nurse Practitioner 8325515539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Corporate Blvd S
Suite 100
Yonkers, NY 10701

100 Corporate Dr
Yonkers, NY 10701-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
681733NYMDRegistered Nurse
356524NYMDFamily Nurse Practitioner

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1619487873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 BARAUD RD N",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105836664",
            "telephone_number": "917-370-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612301",
            "telephone_number": "718-904-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WNUKOWSKI",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356524",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "681733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.