Individual provider Active NPI

Chinyere Ukomadu, PSY.D

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1881113751
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0214221 Issued in NY
Practice address
10 Manhattan Ave
Brooklyn, NY 11206-3950
Phone
(718) 388-3075
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0214221 NY Primary

Addresses

Primary practice location

10 Manhattan Ave
Brooklyn, NY 11206-3950

Mailing address

10 Manhattan Ave
Brooklyn, NY 11206-3950

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200219001823 NY Practitioner - Clinical Psychologist 4880021542 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0214221NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kingsboro Psychiatric Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1881113751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063950",
            "telephone_number": "718-388-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKOMADU",
        "first_name": "CHINYERE",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0214221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.