Individual provider Active NPI

Christiana Temitope Makinde, CPNP

  • Pediatric Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1063668283
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
381921-1 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-3012
Fax
(718) 635-5725
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 381921-1 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

1177 Nelson Ave Apt 3J
Bronx, NY 10452-3625
Phone (718) 538-2648

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
I20110912000385 NY Practitioner - Nurse Practitioner 6507037124 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
381921-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MMC Pediatrics Faculty Practice CurrentSince Jul 3, 2019 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jul 3, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4802 10th Ave
Fl 1
Brooklyn, NY 11219
Phone (212) 427-3986

Networks

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

Interoperability endpoints

  • Direct secure messaging: christianamakinde@mai.allscriptsdirect.net

Organizations & group practices 4

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1063668283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 NELSON AVE APT 3J",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523625",
            "telephone_number": "718-538-2648",
            "fax_number": "718-538-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-3012",
            "fax_number": "718-635-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKINDE",
        "first_name": "CHRISTIANA",
        "middle_name": "TEMITOPE",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381921-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.