NPIMap

Individual provider Active NPI

Osahon Ukponmwan, MD

  • Nephrology Physician
  • Yonkers, NY
National Provider Identifier
1730145194
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
173320 Issued in NY
Practice address
1730 Central Park Ave
Suite 3P
Yonkers, NY 10710-4905
Phone
(914) 779-0141
Fax
(914) 779-0144
NPI assigned
Apr 25, 2006
Last updated
Mar 5, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 173320 NY Primary

Addresses

Primary practice location

1730 Central Park Ave
Suite 3P
Yonkers, NY 10710-4905

Mailing address

1730 Central Park Ave
Suite 3P
Yonkers, NY 10710-4905
Phone (914) 779-0141

Other identifiers 1

IdentifierTypeStateIssuer
01256220MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061010000815 NY Practitioner - Internal MedicinePractitioner - Nephrology 3577569821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yonkers Nephrology PCGroup PAC ID 6709882780, 2 clinicians

Practice addresses (Care Compare)

1730 Central Park Ave
Suite 3P
Yonkers, NY 10710-4905
Phone (914) 761-8287

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Jan 1, 2006 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Jan 1, 2006 Accepting new patients
Latsch Dialysis LLC PastSince Nov 1, 2025 Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482
  • Direct secure messaging: osahon.ukponmwan@direct.davitaphysiciansolutions.com
  • Direct secure messaging: osu9001@direct.nyp.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1730145194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 CENTRAL PARK AVE",
            "address_2": "SUITE 3P",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107104905",
            "telephone_number": "914-779-0141",
            "fax_number": "914-779-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 CENTRAL PARK AVE",
            "address_2": "SUITE 3P",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107104905",
            "telephone_number": "914-779-0141",
            "fax_number": "914-779-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKPONMWAN",
        "first_name": "OSAHON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "173320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01256220",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.