Individual provider Active NPI

Joel Akande Idowu, M.D.

  • Forensic Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1710998778
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
208068 Issued in NY
Practice address
1430 Clove Rd
Staten Island, NY 10301-4300
Phone
(718) 273-6641
Fax
(718) 273-6697
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 208068 NY Primary
Psychiatry Physician 2084P0800X 208068 NY

Addresses

Primary practice location

1430 Clove Rd
Staten Island, NY 10301-4300

Mailing address

1430 Clove Rd
Staten Island, NY 10301-4300
Phone (718) 273-6641

Other identifiers 1

IdentifierTypeStateIssuer
01936727MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041213001082 NY Practitioner - Psychiatry 8820055692 Reassigns benefits to 1 organization
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

690 Castleton Ave
Staten Island, NY 10310-1822
Phone (718) 818-6132

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
208068NYMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC Psychiatry CurrentSince Jan 1, 2011 Accepting new patients
Amboy Medical Practice PC CurrentSince Jan 1, 2011 Accepting new patients
Richmond University Medical Center Past Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710998778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014300",
            "telephone_number": "718-273-6641",
            "fax_number": "718-273-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014300",
            "telephone_number": "718-273-6641",
            "fax_number": "718-273-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU",
        "first_name": "JOEL",
        "middle_name": "AKANDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "208068",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "208068",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01936727",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.