Individual provider Active NPI

Adenike Okeowo

  • Nurse Practitioner
  • Freeport, NY
National Provider Identifier
1205193273
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
320096 Issued in NY
Practice address
160 E Sunrise Hwy # 1104
Freeport, NY 11520-3945
Phone
(631) 517-3293
Fax
(631) 203-0778
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 320096 NY Primary
Licensed Practical Nurse 164W00000X 299946 NY

Addresses

Primary practice location

160 E Sunrise Hwy # 1104
Freeport, NY 11520-3945

Mailing address

160 E Sunrise Hwy # 1104
Freeport, NY 11520-3945
Phone (631) 517-3293

Other practice location 1

169 Riverside Dr
Binghamton, NY 13905-4246
Phone (607) 798-5111

Other practice location 2

347 Union Ave
Staten Island, NY 10303-2470
Phone (917) 459-2388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
299946NYMDEmergency Medicine Physician

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: hyl9025@direct.nyp.org

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1205193273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E SUNRISE HWY # 1104",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203945",
            "telephone_number": "631-517-3293",
            "fax_number": "631-203-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E SUNRISE HWY # 1104",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203945",
            "telephone_number": "631-517-3293",
            "fax_number": "631-203-0778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139054246",
            "country_code": "US",
            "telephone_number": "607-798-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "347 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103032470",
            "country_code": "US",
            "telephone_number": "917-459-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKEOWO",
        "first_name": "ADENIKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "320096",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "299946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.