Individual provider Active NPI

Rebecca Yetunde Omotayo

  • Nurse's Aide
  • Hyattsville, MD
National Provider Identifier
1427428549
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
0000606814 Issued in DC
Practice address
3418 Dodge Park Rd Apt 304
Hyattsville, MD 20785-2039
Phone
(240) 898-7405
NPI assigned
Oct 1, 2015
Last updated
Oct 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X DC
Nurse's Aide 376K00000X 0000606814 DC Primary

Addresses

Primary practice location

3418 Dodge Park Rd Apt 304
Hyattsville, MD 20785-2039

Mailing address

3418 Dodge Park Rd Apt 304
Hyattsville, MD 20785-2039
Phone (240) 898-7405

Other identifiers 2

IdentifierTypeStateIssuer
HHA11359OtherDCHHA
NA0000606814OtherDCNURSING ASSISTANT

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
0000606814DCMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1427428549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 DODGE PARK RD APT 304",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852039",
            "telephone_number": "240-898-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 DODGE PARK RD APT 304",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852039",
            "telephone_number": "240-898-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTAYO",
        "first_name": "REBECCA",
        "middle_name": "YETUNDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "DC",
            "license": "0000606814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HHA",
            "identifier": "HHA11359",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING ASSISTANT",
            "identifier": "NA0000606814",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.