Individual provider Active NPI

Abimbola Jaiyesimi, NP

  • Family Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1013432905
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339272 Issued in NY
Practice address
260 W Sunrise Hwy Ste 200
Valley Stream, NY 11581-1015
Phone
(516) 825-3600
Fax
(516) 872-5137
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F339272 NY Primary

Addresses

Primary practice location

260 W Sunrise Hwy Ste 200
Valley Stream, NY 11581-1015

Mailing address

55 Water St FL 2
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

1991 Marcus Ave Fl 2
New Hyde Park, NY 11042-2057
Phone (516) 354-1600

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409002269 NY Practitioner - Nurse Practitioner 0941639132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

233 Nostrand Ave
Brooklyn, NY 11205-4924
Phone (718) 826-5900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F339272NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Mar 1, 2020 Accepting new patients
Advantagecare Physicians PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

1991 Marcus Ave
Fl 2
New Hyde Park, NY 11042
Phone (516) 354-1600

55 Water St
Fl 2
New York, NY 10041

260 W Sunrise Hwy
Ste 200
Valley Stream, NY 11581
Phone (516) 825-3600

260 W Sunrise Hwy
Valley Stream, NY 11581
Phone (516) 791-4600

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ajaiyesimi26636@direct.acpny.com
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

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": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1013432905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 W SUNRISE HWY STE 200",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811015",
            "telephone_number": "516-825-3600",
            "fax_number": "516-872-5137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Marcus Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110422057",
            "country_code": "US",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIYESIMI",
        "first_name": "ABIMBOLA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.