Individual provider Active NPI

Margaret Omon-Ukpebor, CNP

  • Nurse Practitioner
  • Jamaica Plain, MA
National Provider Identifier
1962160838
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN266084 Issued in MA
Practice address
170 Morton St
Jamaica Plain, MA 02130-3735
Phone
(617) 522-8110
NPI assigned
Dec 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN266084 MA Primary

Addresses

Primary practice location

170 Morton St
Jamaica Plain, MA 02130-3735

Mailing address

150 Moraine St
Brockton, MA 02301-3664
Phone (617) 309-7715

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220728000892 MA Practitioner - Nurse Practitioner 9931581691 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Healthcare Solutions LLCGroup PAC ID 0042376899, 9 clinicians

Practice addresses (Care Compare)

19 Henry St
Sharon, MA 02067-1714
Phone (781) 562-0468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN266084MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apollonia Health Care LLC CurrentSince Aug 22, 2023 Accepting new patients
Ideal Healthcare Solutions LLC Nurse Practitioner CurrentSince Jul 1, 2024 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Nov 6, 2023 Accepting new patients

Locations

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

50 Oliver St
North Easton, MA 02356
Phone (508) 743-5478

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1962160838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MORAINE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013664",
            "telephone_number": "617-309-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-522-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMON-UKPEBOR",
        "first_name": "MARGARET",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN266084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.