Active NPI
Jide Opawoye
- Social Worker
- New York, NY
National Provider Identifier
1104502079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 113469-01
- Practice address
- 400 8TH Avenue 2ND Floor/Chat
New York, NY 10001 - Phone
- (212) 331-3611
- NPI assigned
- Jun 26, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 113469-01 | NY | Primary |
Addresses
Primary practice location
400 8TH Avenue 2ND Floor/Chat
New York, NY 10001
Mailing address
222 Mary Lou Avenue #2
Yonkers, NY 10703
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113469-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1104502079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 MARY LOU AVENUE #2",
"city": "YONKERS",
"state": "NY",
"postal_code": "10703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 8TH AVENUE 2ND FLOOR/CHAT",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10001",
"telephone_number": "212-331-3611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPAWOYE",
"first_name": "JIDE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "113469-01",
"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 Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.