Johan Agudelo, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

408048 Issued in NY

Practice address

5030 Broadway
New York, NY 10034-1609

Phone

(844) 663-2255

NPI assigned

Mar 20, 2026

Last updated

Mar 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Board of Family and Childrens Services IncGroup PAC ID 5092607333, 127 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Jewish Board of Family & Childrens Services Inc

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1689755662
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1773964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1851249114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341609",
            "telephone_number": "844-663-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUDELO",
        "first_name": "JOHAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "408048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burcin Agridag Ucpinar
• Clare Agro, RN
• Christopher James Agrusa
• Lou Ann Marie Agtarap, RN
• Joseph James Aguda III
• Kristin Aguero, LCSW, MPH
• Ingrid Aguiar Littig
• Silvia Helena Aguiar, MD
• Tess Aguiar
• Thalia A Aguiar

• Psychiatric/Mental Health Nurse Practitioner in New York, NY
• Providers in New York, 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 Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.