Individual provider Active NPI

Moryam Omotola Izeghe

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1326924150
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
828137-01 Issued in NY
Practice address
1605 Fulton Ave Apt 4D
Bronx, NY 10457-8239
Phone
(347) 728-5593
NPI assigned
Aug 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 828137-01 NY Primary

Addresses

Primary practice location

1605 Fulton Ave Apt 4D
Bronx, NY 10457-8239

Mailing address

1605 Fulton Avenue
4D
Bronx, NY 10457-8239
Phone (347) 728-5593

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

LicenseStateTypeSpecialty
828137-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1326924150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 FULTON AVENUE",
            "address_2": "4D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104578239",
            "telephone_number": "347-728-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 FULTON AVE APT 4D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104578239",
            "telephone_number": "347-728-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZEGHE",
        "first_name": "MORYAM",
        "middle_name": "OMOTOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "828137-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.