Abidemi Omoyefa

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

510765 Issued in NY

Practice address

1324 Forest Ave Ste 104
Staten Island, NY 10302-2044

Phone

(347) 791-9818

NPI assigned

May 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bidiana Extensions LLC

  • Prosthetic/Orthotic Supplier
  • Staten Island, NY
  • NPI 1396435731
  NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1497445068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 FOREST AVE STE 104",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022044",
            "telephone_number": "347-791-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 FOREST AVE STE 104",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022044",
            "telephone_number": "347-791-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOYEFA",
        "first_name": "ABIDEMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NY",
            "license": "510765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@bidianahair.com",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1324 Forest Ave Ste 104",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103022044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roman Omelchenko, DPT
• Matthew Steven Ominelli, LMHC
• Mojisola Omoaldun I, L.P.N
• Rita Omomhenle
• Mayowa O Omotosho, RN
• Kuduvalli Omprakash, MD
• Sudha K Omprakash, PA
• Osama E Omran, PT, MS. DPT.
• Ego Onaga Consulting Services, M.S.ED
• Chiamaka Onaga, DO

• Prosthetic/Orthotic Supplier in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.