Organization Active NPI

Oseitutu Family Medical PLLC

  • Obesity Medicine (Family Medicine) Physician
  • Rockville Centre, NY
National Provider Identifier
1528536471
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
Legal business name
OSEITUTU FAMILY MEDICAL PLLC
Practice address
30 Hempstead Ave Ste 151
Rockville Centre, NY 11570-4034
Phone
(646) 838-3560
Fax
(646) 838-3569
NPI assigned
Nov 8, 2018
Last updated
Mar 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
Dr. Nanna Oseitutu-Ebanks, MDNPI 1477942597
Title
Owner
Phone
(347) 743-3773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Obesity Medicine (Family Medicine) Physician 207QB0002X NU Primary

Addresses

Primary practice location

30 Hempstead Ave Ste 151
Rockville Centre, NY 11570-4034

Mailing address

488 Allen Ave
Baldwin, NY 11510-3701
Phone (347) 743-3773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190130000520 NY Part B Supplier - Clinic/Group Practice 1951648872 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Locations

165 N Village Ave
Ste 151
Rockville Centre, NY 11570
Phone (646) 838-3560

30 Hempstead Ave
Ste 151
Rockville Ctr, NY 11570
Phone (516) 255-9590

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1528536471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 ALLEN AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103701",
            "telephone_number": "347-743-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HEMPSTEAD AVE STE 151",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704034",
            "telephone_number": "646-838-3560",
            "fax_number": "646-838-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSEITUTU FAMILY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-08",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "OSEITUTU-EBANKS",
        "authorized_official_first_name": "NANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-743-3773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.