Individual provider Active NPI

Adetutu Lateefat Soneye, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1487013629
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NRJ14984600 Issued in NJ
Practice address
118 Dixon Ave
Staten Island, NY 10303-2804
Phone
(516) 234-1183
Fax
(609) 248-0943
NPI assigned
Feb 16, 2016
Last updated
Feb 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NRJ14984600 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NRJ14984600 NJ Primary

Addresses

Primary practice location

118 Dixon Ave
Staten Island, NY 10303-2804

Mailing address

243 Harding Blvd
Matawan, NJ 07747-2912
Phone (516) 234-1183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241011003549 NJ Practitioner - Nurse Practitioner 2163954330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arc Mercer IncGroup PAC ID 1355571308, 7 clinicians

Practice addresses (Care Compare)

1542 Kuser Rd
Suite B7
Hamilton, NJ 08619-3829
Phone (609) 989-9211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NRJ14984600NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arc Mercer, Inc. CurrentSince May 3, 2025 Accepting new patients
Grow Healthcare Group of New Jersey PC Psychiatric/Mental Health CurrentSince Sep 10, 2024 Accepting new patients
Centerpath Wellness, Inc CurrentSince Oct 28, 2024 Accepting new patients

Locations

180 Ewingville Rd
Ewing, NJ 08638

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

117 Roosevelt Ave
Plainfield, NJ 07060
Phone (908) 756-6870

1542 Kuser Rd
Ste B7
Trenton, NJ 08619
Phone (609) 581-1400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772236800000",
    "number": "1487013629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 HARDING BLVD",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472912",
            "telephone_number": "516-234-1183",
            "fax_number": "609-248-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 DIXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032804",
            "telephone_number": "516-234-1183",
            "fax_number": "609-248-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONEYE",
        "first_name": "ADETUTU",
        "middle_name": "LATEEFAT",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NRJ14984600",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NRJ14984600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.