Individual provider Active NPI

Ben Osuala, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1699068965
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F346652-01 Issued in NY
Practice address
151 Ada Dr
Staten Island, NY 10314-1416
Phone
(646) 406-1875
NPI assigned
May 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F346652-01 NY Primary

Addresses

Primary practice location

151 Ada Dr
Staten Island, NY 10314-1416

Mailing address

151 Ada Dr
Staten Island, NY 10314-1416
Phone (646) 406-1875

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
I20230127002632 NY Practitioner - Nurse Practitioner 8820469919 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Perry Ave Family Medical Center IncGroup PAC ID 0547365363, 28 clinicians

Practice addresses (Care Compare)

3071 Perry Ave
Bronx, NY 10467-4111
Phone (718) 231-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F346652-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Mar 13, 2024 Accepting new patients
Perry Ave Family Medical Center Inc CurrentSince Nov 1, 2022 Accepting new patients
Andrade Medical PLLC CurrentSince May 6, 2023 Accepting new patients
Maimonides Medical Center Division of Otolaryngology FPP PastSince Oct 1, 2013 Accepting new patients

Locations

1163 Manor Ave
Frnt 2
Bronx, NY 10472
Phone (718) 589-3501

3071 Perry Ave
Bronx, NY 10467
Phone (718) 231-6700

6323 7th Ave
Brooklyn, NY 11220
Phone (718) 283-6980

1250 57th St
Brooklyn, NY 11219
Phone (718) 283-5700

745 64th St
Brooklyn, NY 11220
Phone (718) 765-2570

6300 8th Ave
Brooklyn, NY 11220
Phone (718) 765-2600

948 48th St
Brooklyn, NY 11219
Phone (718) 283-7219

919 49th St
Brooklyn, NY 11219
Phone (718) 283-6260

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ben.osuala.1@24989.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1699068965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 ADA DR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141416",
            "telephone_number": "646-406-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 ADA DR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141416",
            "telephone_number": "646-406-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSUALA",
        "first_name": "BEN",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346652-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.