Individual provider Active NPI

Yaw Adom, FNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1073878302
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F346658 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
Jul 12, 2012
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F346658 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

1434 Williamsbridge Rd FL 2
Bronx, NY 10461-2507
Phone (718) 618-0401

Other practice location 1

2054 Tillotson Ave
Bronx, NY 10475-1560
Phone (718) 671-2100

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL BRONX
Other URL BRONX

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
I20210331000699 NY Practitioner - Nurse Practitioner 0345657797 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F346658NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Urgent Care PLLC CurrentSince Aug 4, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 21, 2021 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 21, 2021 Accepting new patients
Divinity Medical Services PLLC CurrentSince Feb 21, 2024 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Mar 21, 2021 Accepting new patients
Bronx Medical Practice P.C. Past Accepting new patients

Locations

100 Challenger Rd
Ste 303
Ridgefield Pk, NJ 07660

1009 E 163rd St
Bronx, NY 10459
Phone (718) 542-4200

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

1434 Williamsbridge Rd
Fl 2
Bronx, NY 10461
Phone (201) 641-2125

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2865 3rd Ave
Bronx, NY 10455
Phone (718) 703-7878

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

875 Utica Ave
Brooklyn, NY 11203
Phone (718) 964-6066

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1073878302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 WILLIAMSBRIDGE RD FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2054 Tillotson Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104751560",
            "country_code": "US",
            "telephone_number": "718-671-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADOM",
        "first_name": "YAW",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BRONX",
            "affiliation": "N",
            "address_1": "1009 E 163rd St",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104594308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BRONX",
            "affiliation": "N",
            "address_1": "1009 E 163rd St",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104594308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.