Kennedy Onome Omonuwa, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

245036 Issued in NY

Practice address

410 Lakeville Rd Ste 107
New Hyde Park, NY 11042-1102

Phone

(516) 465-5400

Fax

(516) 465-5454

NPI assigned

Jul 24, 2007

Last updated

Jul 24, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lincoln Medical & Mental Health Center Hospital, Bronx, NY, CCN 330080
• Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: komonuwa840148@nychhc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment Care Compare group NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Digestive Disease Care, PC

  • Gastroenterology Physician
  • East Setauket, NY
  • NPI 1184871774
  NPD (past)
• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  NPD (past)
• New York City Health and Hospitals Corporation

  dba Lincoln Medical And Mental Health Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1427063270

  Internal Medicine

  NPD (past)
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679

  Internal Medicine

  NPD (past)
• New York Walk-in Medical Group, PC

  • Family Medicine Physician
  • New York, NY
  • NPI 1083814974
  NPD (past)
• Queens Medical Services PLLC

  • Family Medicine Physician
  • Corona, NY
  • NPI 1487745816

  Internal Medicine

  NPD (past)

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

• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  Care Compare affiliation
• New York City Health and Hospitals Corporation

  dba Lincoln Medical And Mental Health Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1427063270
  Care Compare affiliation

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1730389172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 107",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421102",
            "telephone_number": "516-465-5400",
            "fax_number": "516-465-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 107",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421102",
            "telephone_number": "516-465-5400",
            "fax_number": "516-465-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMONUWA",
        "first_name": "KENNEDY",
        "middle_name": "ONOME",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alessandra Olsen, NP
• Ryanne Olsen
• Nicholas Robert Olson, MD
• Katherine Bridget Omalley, PA-C
• Justine Sarah Cummins Oman, MD
• Kemi A Omotoso, MD, MHSA
• Young Ono, MD
• Ashley Rose Oommen, PA
• Cecil Oommen
• Ryan Oommen, DPT

• Internal Medicine Physician in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.