Individual provider Active NPI

Abiodun Akinbobola, RN

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1023387248
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F347060 Issued in NY
Practice address
266 Graff Ave
Bronx, NY 10465-3119
Phone
(347) 641-3592
NPI assigned
Dec 16, 2011
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F347060 NY Primary
Registered Nurse 163W00000X 649682 NY

Addresses

Primary practice location

266 Graff Ave
Bronx, NY 10465-3119

Mailing address

266 Graff Ave # 21B
Bronx, NY 10465-3119
Phone (347) 641-3592

Other identifiers 3

IdentifierTypeStateIssuer
F347060MedicaidNY
649682OtherNYRN LICENSE
F347060OtherNYFNP

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
I20211102001063 NY Practitioner - Nurse Practitioner 1254729775 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
649682NYMDRegistered Nurse
F347060NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Health PC CurrentSince Jun 12, 2023 Accepting new patients
Care Connect Medical P.C. CurrentSince Sep 1, 2023 Accepting new patients
Medical Director Services PC CurrentSince Sep 1, 2021 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

2316 Bruner Ave
Bronx, NY 10469
Phone (718) 882-6400

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

7 Skyline Dr
Ste 250
Hawthorne, NY 10532

15 Monsey Blvd
Monsey, NY 10952
Phone (845) 356-3400

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

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1023387248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 GRAFF AVE # 21B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653119",
            "telephone_number": "347-641-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 GRAFF AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653119",
            "telephone_number": "347-641-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINBOBOLA",
        "first_name": "ABIODUN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-16",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F347060",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "649682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F347060",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "649682",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP",
            "identifier": "F347060",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.