Individual provider Active NPI

Lydia Adebola Onatunde, ARNP

  • Acute Care Nurse Practitioner
  • Longwood, FL
National Provider Identifier
1023486032
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
ARNP9175385 Issued in FL
Practice address
2062 Ackola PT
Longwood, FL 32779-3112
Phone
(321) 287-5404
NPI assigned
Sep 8, 2015
Last updated
Sep 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X ARNP9175385 FL Primary

Addresses

Primary practice location

2062 Ackola PT
Longwood, FL 32779-3112

Mailing address

2062 Ackola PT
Longwood, FL 32779-3112
Phone (321) 287-5404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, IN, OH, GA, IA, MD, NY, DC8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20231003002024 VA Practitioner - Nurse Practitioner 6507145521 Reassigns benefits to 1 organization
I20231030000649 IN Practitioner - Nurse Practitioner 6507145521 Reassigns benefits to 1 organization
I20231030000860 OH Practitioner - Nurse Practitioner 6507145521 Reassigns benefits to 1 organization
I20240206000383 GA Practitioner - Nurse Practitioner 6507145521 Reassigns benefits to 1 organization
I20240704000330 IA Practitioner - Nurse Practitioner 6507145521 Reassigns benefits to 1 organization
I20250122000438 MD Practitioner - Nurse Practitioner 6507145521
I20250626000696 NY Practitioner - Nurse Practitioner 6507145521
I20260420002600 DC Practitioner - Nurse Practitioner 6507145521 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

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 150
Cerritos, CA 90703-9329

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
433300NYMDRegistered Nurse
ARNP9175385FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carelon Medical Partners of Kansas, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lonatunde20859@carelonhealth.direct-ci.com

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, 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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1023486032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2062 ACKOLA PT",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327793112",
            "telephone_number": "321-287-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2062 ACKOLA PT",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327793112",
            "telephone_number": "321-287-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONATUNDE",
        "first_name": "LYDIA",
        "middle_name": "ADEBOLA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9175385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.