Individual provider Active NPI

Adeyemo Dania

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Albans, NY
National Provider Identifier
1083148225
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405779 Issued in NY
Practice address
19115 115TH Ave
Saint Albans, NY 11412-2727
Phone
(929) 309-3374
NPI assigned
Apr 14, 2017
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F405779 NY Primary
Licensed Practical Nurse 164W00000X 320346 NY

Addresses

Primary practice location

19115 115TH Ave
Saint Albans, NY 11412-2727

Mailing address

19115 115TH Ave
Saint Albans, NY 11412-2727
Phone (929) 309-3374

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
I20250820001331 NY Practitioner - Nurse Practitioner 4082113519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034

463 Fashion Ave
FL 18
New York, NY 10018-7595

497 Rockaway Ave
Valley Stream, NY 11581-1909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
320346NYMDLicensed Practical Nurse
F405779NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family & Childrens Services Inc CurrentSince Aug 1, 2025 Accepting new patients
Jewish Board of Family and Children's Services, Inc. Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Jewish Board of Family and Children's Services, Inc Past Accepting new patients

Locations

3600 Jerome Ave
Bronx, NY 10467
Phone (718) 366-8400

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

2020 Coney Island Ave
Brooklyn, NY 11223
Phone (718) 676-4210

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, 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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1083148225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19115 115TH AVE",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122727",
            "telephone_number": "929-309-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19115 115TH AVE",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122727",
            "telephone_number": "929-309-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIA",
        "first_name": "ADEYEMO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405779",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "320346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, NY

Sources for this page

Verify at the official NPI Registry.