Individual provider Active NPI

Nolirat Adebisi Adeyemi

  • Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1255937819
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F346780-01 Issued in NY
Practice address
31 Standish Rd
Valley Stream, NY 11580-1131
Phone
(917) 627-2350
NPI assigned
Dec 9, 2020
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 F346780-01 NY Primary
Inpatient Obstetric Registered Nurse 163WX0003X 346780 NY

Addresses

Primary practice location

31 Standish Rd
Valley Stream, NY 11580-1131

Mailing address

31 Standish Rd
Valley Stream, NY 11580-1131

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
I20221027001767 NY Practitioner - Nurse Practitioner 2466829882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346780NYMDInpatient Obstetric Registered Nurse
F346780-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 29, 2022 Accepting new patients
New York University CurrentSince Aug 29, 2022 Accepting new patients
Matrix Medical of New York PC Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
Urban Family Practice PC Nurse Practitioner Past Accepting new patients

Locations

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

333 E 38th St
New York, NY 10016
Phone (646) 501-7070

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Interoperability endpoints

  • Direct secure messaging: nolirat.adeyemi@cinq-nyipa.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1255937819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 STANDISH RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 STANDISH RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801131",
            "telephone_number": "917-627-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYEMI",
        "first_name": "NOLIRAT",
        "middle_name": "ADEBISI",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F346780-01",
            "primary": true
        },
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "NY",
            "license": "346780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.