Active NPI
O.B. Adult Health Nurse Practitioner Services PC
- Clinic/Center
- Staten Island, NY
National Provider Identifier
1164933487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- F307489
- Legal business name
- O.B. ADULT HEALTH NURSE PRACTITIONER SERVICES PC
- Practice address
- 209 Broad St
Staten Island, NY 10304-2105 - Phone
- (917) 374-9180
- Fax
- (718) 448-7263
- NPI assigned
- Oct 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Olasunkanmi Bhadmus, NURSE PRACTITIONER
- Title
- Assistant Director
- Phone
- (917) 374-9180
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | F307489 | NY | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | F307489 | NY | |
| Gerontology Clinical Nurse Specialist | 364SG0600X | 573342 | NY |
Addresses
Primary practice location
209 Broad St
Staten Island, NY 10304-2105
Mailing address
224 Osgood Ave
Staten Island, NY 10304-3607
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
979 Bay St
Ste 3
Staten Island, NY 10305
Phone (917) 830-1838
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Brooklyn, NY
- NPI 1417263328
-
- Psychiatry Physician
- Brooklyn, NY
- NPI 1629011333
-
- Psychiatric/Mental Health Nurse Practitioner
- Staten Island, NY
- NPI 1932509767
-
- Cardiovascular Disease Physician
- Forest Hills, NY
- NPI 1528054137
-
- Pain Medicine Physician
- Bayside, NY
- NPI 1548200967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507852800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1541116800000",
"number": "1164933487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 OSGOOD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103043607",
"fax_number": "718-448-7263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 BROAD ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103042105",
"telephone_number": "917-374-9180",
"fax_number": "718-448-7263"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "O.B. ADULT HEALTH NURSE PRACTITIONER SERVICES PC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-13",
"last_updated": "2018-11-02",
"status": "A",
"authorized_official_last_name": "BHADMUS",
"authorized_official_first_name": "OLASUNKANMI",
"authorized_official_title_or_position": "ASSISTANT DIRECTOR",
"authorized_official_telephone_number": "917-374-9180",
"authorized_official_credential": "NURSE PRACTITIONER"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NY",
"license": "F307489",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F307489",
"primary": false
},
{
"code": "364SG0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Gerontology",
"state": "NY",
"license": "573342",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.