Individual provider Active NPI

Vaneesa Fayemiwo

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1023924164
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
408938 Issued in NY
Practice address
419 W 114TH St
New York, NY 10025-1710
Phone
(516) 717-5510
NPI assigned
Aug 19, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 408938 NY Primary

Addresses

Primary practice location

419 W 114TH St
New York, NY 10025-1710

Mailing address

14371 243Rd St
Rosedale, NY 11422-2339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1023924164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14371 243RD ST",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W 114TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251710",
            "telephone_number": "516-717-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYEMIWO",
        "first_name": "VANEESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "408938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.