Individual provider Active NPI

Charles Obum Okoye

  • Primary Care Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1154876571
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F358105 Issued in NY
Practice address
11942 179TH St
Jamaica, NY 11434-1942
Phone
(646) 379-7550
NPI assigned
Aug 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F358105 NY Primary

Addresses

Primary practice location

11942 179TH St
Jamaica, NY 11434-1942

Mailing address

11942 179TH St
Jamaica, NY 11434-1942
Phone (646) 379-7550

Other names 1

  • Mr. Obum Charles Okoye Other name

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
I20260612001477 NY Practitioner - Nurse Practitioner 4688146418 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11942 179TH Street
jamaica, NY 11434

2626 Halperin Ave
FL 1
Bronx, NY 10461-2631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F358105NYMDPrimary Care Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1154876571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11942 179TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341942",
            "telephone_number": "646-379-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11942 179TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341942",
            "telephone_number": "646-379-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOYE",
        "first_name": "CHARLES",
        "middle_name": "OBUM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-16",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F358105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OBUM",
            "last_name": "OKOYE",
            "middle_name": "CHARLES",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.