Individual provider Active NPI

Adetinuke Motunrayo Ogunleye, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1134860208
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001012172 Issued in NC
Practice address
874 Flatbush Ave
Brooklyn, NY 11226-3102
Phone
(718) 571-9372
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001012172 NC
Physician Assistant 363A00000X 001012172 NC Primary

Addresses

Primary practice location

874 Flatbush Ave
Brooklyn, NY 11226-3102

Mailing address

3479 Forestdale Dr Apt 2a
Burlington, NC 27215-8210
Phone (631) 219-3973

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
I20220921003567 NY Practitioner - Physician Assistant 1355726761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

1243 Fulton St
Brooklyn, NY 11216-2004
Phone (646) 647-1257

21 Graham Ave
Brooklyn, NY 11206-4007
Phone (718) 571-9280

228 - 230 Court St
Brooklyn, NY 11201-6405
Phone (718) 280-5362

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

457 Atlantic Ave
Brooklyn, NY 11217-2107
Phone (718) 530-1144

461 Fulton St
Brooklyn, NY 11201-5207
Phone (718) 571-9418

874 Flatbush Ave
Brooklyn, NY 11226-3102
Phone (718) 571-9372

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028373NYMDPediatric Occupational Therapist
001012172NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jul 27, 2022 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jul 27, 2022 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

874 Flatbush Ave
Brooklyn, NY 11226
Phone (718) 571-9372

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: adetinuke.ogunleye.1@2983.direct.athenahealth.com

Organizations & group practices 3

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1134860208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3479 FORESTDALE DR APT 2A",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158210",
            "telephone_number": "631-219-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263102",
            "telephone_number": "718-571-9372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNLEYE",
        "first_name": "ADETINUKE",
        "middle_name": "MOTUNRAYO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001012172",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001012172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.