Individual provider Active NPI

Feyisayo Omotoso

  • Licensed Practical Nurse
  • Far Rockaway, NY
National Provider Identifier
1437761087
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
338490 Issued in NY
Practice address
193 Beach 29TH St Apt 2
Far Rockaway, NY 11691-2149
Phone
(347) 220-2633
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 338490 NY Primary

Addresses

Primary practice location

193 Beach 29TH St Apt 2
Far Rockaway, NY 11691-2149

Mailing address

193 Beach 29TH St Apt 2
Far Rockaway, NY 11691-2149
Phone (347) 220-2633

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

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1437761087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 BEACH 29TH ST APT 2",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912149",
            "telephone_number": "347-220-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 BEACH 29TH ST APT 2",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912149",
            "telephone_number": "347-220-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTOSO",
        "first_name": "FEYISAYO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "338490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.