Active NPI
Mustapha Adekunle Ajose
- Licensed Practical Nurse
- Staten Island, NY
National Provider Identifier
1225677289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 3326571
- Practice address
- 861 Forest Ave Apt 2
Staten Island, NY 10310-2439 - Phone
- (347) 856-4177
- NPI assigned
- Dec 22, 2019
- Last updated
- Dec 22, 2019
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 3326571 | NY | Primary |
Addresses
Primary practice location
861 Forest Ave Apt 2
Staten Island, NY 10310-2439
Mailing address
861 Forest Ave Apt 2
Staten Island, NY 10310-2439
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mka6088@live.com | Direct | |
| CONNECT URL | computer | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 3326571 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576972800000",
"number": "1225677289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "861 FOREST AVE APT 2",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "861 FOREST AVE APT 2",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102439",
"telephone_number": "347-856-4177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AJOSE",
"first_name": "MUSTAPHA",
"middle_name": "ADEKUNLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-22",
"last_updated": "2019-12-22",
"certification_date": "2019-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "3326571",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mka6088@live.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "861 Forest Ave Apt 2",
"city": "Staten Island",
"state": "NY",
"country_code": "US",
"postal_code": "103102439",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "computer",
"affiliation": "N",
"endpointDescription": "computer",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "861 Forest Ave Apt 2",
"city": "Staten Island",
"state": "NY",
"country_code": "US",
"postal_code": "103102439",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.