Individual provider Active NPI

Jennifer Ekwutosi Adjara, NP

  • Nurse Practitioner
  • Albany, NY
National Provider Identifier
1659645158
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
305738 Issued in NY
Practice address
7 Southwoods Blvd
Albany, NY 12211
Phone
(518) 292-6000
Fax
(518) 292-6087
NPI assigned
Feb 29, 2012
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 340820 NY
Nurse Practitioner 363L00000X 305738 NY Primary

Addresses

Primary practice location

7 Southwoods Blvd
Albany, NY 12211

Mailing address

7 Southwoods Blvd
Albany, NY 12211
Phone (518) 292-6000

Other practice location 1

47 New Scotland Ave
Mail Code 70
Albany, NY 12208-3412
Phone (518) 262-5226

Other names 1

  • Jennifer Iwumune Former name

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
I20140401001490 NY Practitioner - Nurse Practitioner 0547491706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Cardiology Associates PLLCGroup PAC ID 1254228240, 72 clinicians

Practice addresses (Care Compare)

2200 Burdett Ave
Suite 202
Troy, NY 12180-2451
Phone (518) 292-6200

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3125

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340820NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Healthcare Services PLLC Nurse Practitioner Current Accepting new patients
Albany Medical College CurrentSince Dec 2, 2013 Accepting new patients
Albany Medical College Nurse Practitioner Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Nurse Practitioner CurrentSince Dec 2, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC Nurse Practitioner CurrentSince Sep 27, 2017 Accepting new patients
R.G. Psychological Services, P.C. Past Accepting new patients
Burdett Orthopedics, PC PastSince Mar 1, 2010 Accepting new patients
Albany Medical College Nurse Practitioner Past Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#70
Albany, NY 12208
Phone (518) 262-5226

7 Southwoods Blvd
Albany, NY 12211
Phone (518) 292-6060

7 Southwoods Blvd
Ste 4
Albany, NY 12211

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

820 Albany Shaker Rd
Loudonville, NY 12211
Phone (518) 869-2231

2902 Upper Tibbits Ave
Troy, NY 12180
Phone (518) 273-2040

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

Interoperability endpoints

  • Direct secure messaging: jadjara788571@direct.trinity-health.org
  • Direct secure messaging: ms_jadjara@landmarkhealth-direct.org

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1659645158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SOUTHWOODS BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12211",
            "telephone_number": "518-292-6000",
            "fax_number": "518-292-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SOUTHWOODS BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12211",
            "telephone_number": "518-292-6000",
            "fax_number": "518-292-6087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Mail Code 70",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-5226",
            "fax_number": "518-262-6261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADJARA",
        "first_name": "JENNIFER",
        "middle_name": "EKWUTOSI",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340820",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "305738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "IWUMUNE",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.