Individual provider Active NPI

Atinuke Ogunlade-Addams, MD

  • Psychiatry Physician
  • Elmira, NY
National Provider Identifier
1083679690
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
231915 Issued in NY
Practice address
206 W Water St
Elmira, NY 14901-2913
Phone
(607) 857-1095
Fax
(607) 857-1095
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 231915-1 NY
Psychiatry Physician 2084P0800X 231915 NY Primary

Addresses

Primary practice location

206 W Water St
Elmira, NY 14901-2913

Mailing address

963 Walnut St
Elmira, NY 14901-1831
Phone (607) 734-1447

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040827000973 NY Practitioner - PsychiatryPractitioner - Addiction Medicine 1759356314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
231915-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Oct 12, 2019 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Oct 12, 2019 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Nys Office of Mental Health Past Accepting new patients
Pathways, Inc. PastSince Nov 3, 2022 Accepting new patients
County of Wayne PastSince May 1, 2001 Accepting new patients
Clinical Social Work and Counseling Services of the Finger Lakes PastSince Aug 1, 1992 Accepting new patients

Locations

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Organizations & group practices 7

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1083679690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 WALNUT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011831",
            "telephone_number": "607-734-1447",
            "fax_number": "607-737-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149012913",
            "telephone_number": "607-857-1095",
            "fax_number": "607-857-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNLADE-ADDAMS",
        "first_name": "ATINUKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "231915-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "231915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.