Individual provider Active NPI

Prudence A Osei-Tutu Sr., M.D.

  • Pediatric Adolescent Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1447308697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
145501 Issued in NY
Practice address
84 Linden Blvd
Brooklyn, NY 11226-3301
Phone
(718) 826-1355
Fax
(718) 462-3940
NPI assigned
Jan 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 145501 NY Primary

Addresses

Primary practice location

84 Linden Blvd
Brooklyn, NY 11226-3301

Mailing address

84 Linden Blvd
Brooklyn, NY 11226-3301
Phone (718) 826-1355

Other identifiers 1

IdentifierTypeStateIssuer
7184623940OtherNY3267

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
145501NYMDPediatric Adolescent Medicine Physician

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447308697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263301",
            "telephone_number": "718-826-1355",
            "fax_number": "718-462-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263301",
            "telephone_number": "718-826-1355",
            "fax_number": "718-462-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSEI-TUTU",
        "first_name": "PRUDENCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "145501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "3267",
            "identifier": "7184623940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.