Individual provider Active NPI

Iyabo Aina Onifade, NP

  • Primary Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1386172112
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F308163 Issued in NY
Practice address
216 E 99TH St
New York, NY 10029-6808
Phone
(877) 226-8500
NPI assigned
May 24, 2017
Last updated
May 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F308163 NY Primary

Addresses

Primary practice location

216 E 99TH St
New York, NY 10029-6808

Mailing address

89 Andros Ave
Staten Island, NY 10303-2048

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
I20191003002437 NY Practitioner - Nurse Practitioner 5698049005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F308163NYMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1386172112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ANDROS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 E 99TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296808",
            "telephone_number": "877-226-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONIFADE",
        "first_name": "IYABO",
        "middle_name": "AINA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F308163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.