Active NPI
Olumide Adeyekun, MD
- Student in an Organized Health Care Education/Training Program
- Glen Cove, NY
National Provider Identifier
1023767134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 101 Saint Andrews LN
Glen Cove, NY 11542-2254 - Phone
- (516) 674-7300
- NPI assigned
- Mar 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Mailing address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (516) 674-7300
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250715002270 | NY | Practitioner - Hospitalist | 4183139504 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2356
Hospital & facility affiliations
- NS/Lij HS Huntington Hospital
- Memorial Hospital for Cancer and Allied Diseases
- North Shore University Hospital
- NYU Langone Hospitals
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients |
Locations
101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300
270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
300 Community Dr
Plandome, NY 11030
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Organizations & group practices 1
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.
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
Hospital
-
- Special Hospital
- New York, NY
- NPI 1770046351
Hospital
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1023767134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SAINT ANDREWS LN",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115422254",
"telephone_number": "516-674-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SAINT ANDREWS LN",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115422254",
"telephone_number": "516-674-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEYEKUN",
"first_name": "OLUMIDE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-23",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Cove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.