Individual provider Active NPI

Golder Kportufe

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1700495009
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
793099 Issued in NY
Practice address
280 Park Hill Ave Apt 6C
Staten Island, NY 10304-4612
Phone
(347) 324-4088
NPI assigned
Jul 23, 2020
Last updated
Jul 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 793099 NY Primary

Addresses

Primary practice location

280 Park Hill Ave Apt 6C
Staten Island, NY 10304-4612

Mailing address

280 Park Hill Ave Apt 6C
Staten Island, NY 10304-4612
Phone (347) 324-4088

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

State licenses

LicenseStateTypeSpecialty
793099NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1700495009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 PARK HILL AVE APT 6C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044612",
            "telephone_number": "347-324-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PARK HILL AVE APT 6C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044612",
            "telephone_number": "347-324-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KPORTUFE",
        "first_name": "GOLDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "793099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.