Audracy Genia Massakidi Mboussi

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F407919 Issued in NY

Practice address

1182 Chenango St
Binghamton, NY 13901-1653

Phone

(607) 296-3072

NPI assigned

Jan 21, 2026

Last updated

Jun 26, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1700745999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 CHENANGO ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139011653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 CHENANGO ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139011653",
            "telephone_number": "607-296-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSAKIDI MBOUSSI",
        "first_name": "AUDRACY GENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F407919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02997780",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina M Martinkovic, LCSW
• David John Martinkovic, LMSW
• Emma Lynn Marvin
• Mary Michael, DDS, P.C.
• Lisa C Mason, LPN
• Amanda Massar, PT, DPT
• Daniel Massengale, CRNA
• Ana Marie Masso
• Jamie Lyn Masson, MD
• Dante D Mastronardi

• Psychiatric/Mental Health Nurse Practitioner in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.