Individual provider Active NPI

Oladunni Ogundipe

  • Student in an Organized Health Care Education/Training Program
  • Stony Brook, NY
National Provider Identifier
1346828746
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
101 Nicolls Road
LVL 9 RM 020
Stony Brook, NY 11794-8091
Phone
(631) 444-2739
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

101 Nicolls Road
LVL 9 RM 020
Stony Brook, NY 11794-8091

Mailing address

101 Nicolls Rd RM 20
Stony Brook, NY 11794-8091
Phone (631) 444-2739

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251226000206 NY Practitioner - Obstetrics/Gynecology 5991291197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
338169NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 18, 2025 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

Networks

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1346828746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD RM 20",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948091",
            "telephone_number": "631-444-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "LVL 9 RM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948091",
            "telephone_number": "631-444-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIPE",
        "first_name": "OLADUNNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.