Individual provider Active NPI

Grace Nwakaego Onovo, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, NY
National Provider Identifier
1659393510
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402494 Issued in NY
Practice address
6 Gramatan Ave Ste 604a
Mount Vernon, NY 10550-3208
Phone
(838) 333-0513
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F333959 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402494 NY Primary

Addresses

Primary practice location

6 Gramatan Ave Ste 604a
Mount Vernon, NY 10550-3208

Mailing address

11 Emmett Ter
New Rochelle, NY 10805-1201
Phone (914) 636-2765

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
I20050816000256 NY Practitioner - Nurse Practitioner 5890725261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Emmett Ter
New Rochelle, NY 10805-1201
Phone (838) 333-0513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F333959NYMDFamily Medicine Physician
F402494NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Damian Family Care Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Grace Onovo NP in Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jun 7, 2021 Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients
Lyons Medical Care, PLLC Past Accepting new patients
Bronx Addiction Services Integrated Concepts System Inc PastSince Jan 20, 2009 Accepting new patients

Locations

8956 162nd St
#3
Jamaica, NY 11432
Phone (718) 297-8000

6 Gramatan Ave
Ste 604A
Mount Vernon, NY 10550
Phone (838) 333-0513

Organizations & group practices 6

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1659393510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EMMETT TER",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051201",
            "telephone_number": "914-636-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GRAMATAN AVE STE 604A",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503208",
            "telephone_number": "838-333-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONOVO",
        "first_name": "GRACE",
        "middle_name": "NWAKAEGO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F333959",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.