Lara K. Ogundiran, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F382296-1 Issued in NY

Practice address

4811 Buckley Rd
Liverpool, NY 13088-3629

Phone

(315) 457-9966

Fax

(315) 457-9854

NPI assigned

Jul 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Networks

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

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.

• Joseph P. Addabbo Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Arverne, NY
  • NPI 1831307628
  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1386909786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 BUCKLEY RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883629",
            "telephone_number": "315-457-9966",
            "fax_number": "315-457-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 BUCKLEY RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883629",
            "telephone_number": "315-457-9966",
            "fax_number": "315-457-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIRAN",
        "first_name": "LARA",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382296-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mary Oconnor, DDS
• Fuyuko Ikehara Oddy, D.C.
• Nicole Michelle Odom
• Patrick Rafael Oellers, MD
• Stacy Oglesby
• Matthew S Ohern, MD
• Ifeanyi Victor Okwor, B.PHARM
• Anthony S Oliva, M.D.,
• Mary Olson, RBT
• Ronald Ommen, DDS

• Pediatric Nurse Practitioner in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.