Yewande Temitope Mikoku, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

403469 Issued in NY

Practice address

27 Dixon Ave
Staten Island, NY 10302-1938

Phone

(917) 841-6757

NPI assigned

May 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Yewande Temitope Makanjuola Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HCDDDD/Endpoint/HCDDDD

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.

• St. Joseph'S Hospital Yonkers

  • Anatomic Pathology & Clinical Pathology Physician
  • Yonkers, NY
  • NPI 1356316921
  Medicare reassignment NPD
• Yewande Mikoku NP in Psychiatry PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Staten Island, NY
  • NPI 1275380586
  NPD Authorized official
• St Josephs Hospital Yonkers

  • General Acute Care Hospital
  • Harrison, NY
  • NPI 1679883037
  NPD
• St.Vincent' Hospital Westchester Psych

  • Counseling Psychologist
  • Harrison, NY
  • NPI 1932400140
  NPD
• St.Vincent'S Hospital Westchester

  • Adult Mental Health Clinic/Center
  • Staten Island, NY
  • NPI 1326434515
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1508079294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 DIXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021938",
            "telephone_number": "917-841-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 DIXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021938",
            "telephone_number": "917-841-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOKU",
        "first_name": "YEWANDE",
        "middle_name": "TEMITOPE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "403469",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "559805-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEWANDE",
            "last_name": "MAKANJUOLA",
            "middle_name": "TEMITOPE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mena Youssef Mikhail, MD
• Samy Mikhail
• Volha Mikhailava, MS
• Alex Mikhelson, MD
• Jacqueline Mikhly, D.M.D.
• Victoria Milata
• Heather Joy Milatta
• Jeanine Milazzo
• Miles of Smiles Inc
• Milestones in Motion Physical Therapy Wellness, PC

• Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.