NPIMap

Organization Active NPI

Chukwuka S Mordi, NP Psychiatry PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rosedale, NY
National Provider Identifier
1720602691
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CHUKWUKA S MORDI, NP PSYCHIATRY PC
Practice address
24101 Newhall Ave
Rosedale, NY 11422-2408
Phone
(347) 693-4311
NPI assigned
Jun 5, 2020
Last updated
Jun 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Authorized official

Name
Dr. Chukwuka Mordi, FPMHNPNPI 1962708529
Title
Director of Psychiatry
Phone
(347) 693-4311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary
Mental Health Counselor 101YM0800X NU
Pastoral Counselor 101YP1600X NU
Clinical Social Worker 1041C0700X NU
Addiction Psychiatry Physician 2084P0802X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU

Addresses

Primary practice location

24101 Newhall Ave
Rosedale, NY 11422-2408

Mailing address

32 N Montague St
Valley Stream, NY 11580-3708
Phone (347) 693-4311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200730001473 NY Part B Supplier - Clinic/Group Practice 0749605301 Receives reassigned benefits from 1 practitioner
Practice locations: Rosedale, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1720602691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 N MONTAGUE ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115803708",
            "telephone_number": "347-693-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24101 NEWHALL AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222408",
            "telephone_number": "347-693-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUKWUKA S MORDI, NP PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "MORDI",
        "authorized_official_first_name": "CHUKWUKA",
        "authorized_official_title_or_position": "DIRECTOR OF PSYCHIATRY",
        "authorized_official_telephone_number": "347-693-4311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FPMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.