NPIMap

Organization Active NPI

Yewande Mikoku NP in Psychiatry PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1275380586
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
YEWANDE MIKOKU NP IN PSYCHIATRY PC
Practice address
27 Dixon Ave
Staten Island, NY 10302-1938
Phone
(917) 841-6757
NPI assigned
May 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Authorized official

Name
Yewande Mikoku, NP-PMHNPI 1508079294
Title
Owner
Phone
(917) 841-6757

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

27 Dixon Ave
Staten Island, NY 10302-1938

Mailing address

27 Dixon Ave
Staten Island, NY 10302-1938
Phone (917) 841-6757

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1275380586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 DIXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021938",
            "telephone_number": "917-841-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 DIXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021938",
            "telephone_number": "917-841-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YEWANDE MIKOKU NP IN PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "MIKOKU",
        "authorized_official_first_name": "YEWANDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-841-6757",
        "authorized_official_credential": "NP-PMH"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.