Iyen Stacey Ighodaro, DNP, FNP-BC, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ01426300 Issued in NJ

Practice address

197 Hillside Ave
Livingston, NJ 07039-3648

Phone

(646) 633-1525

NPI assigned

Jan 25, 2023

Sex

Female

Sole proprietor

Yes

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Rutgers New Jersey Medical School, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Perry Ave Family Medical Center Inc

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1619973518
  Medicare reassignment NPD
• SSP Home Healthcare LLC

  • Home Health Agency
  • Livingston, NJ
  • NPI 1164280350
  NPD Authorized official

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1730895558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 HILLSIDE AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393648",
            "telephone_number": "646-633-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 HILLSIDE AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393648",
            "telephone_number": "646-633-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGHODARO",
        "first_name": "IYEN",
        "middle_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01426300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hypertension and Renal Group, P.a.
• Christin Hywel, OTR
• Yasmine Ibrahim
• Identity Physical Therapy LLC
• Jade Heather Igbokwe, AU.D.
• Nico Ignozza
• Elizabeth Ijalba, CCC
• Imaging Consultants of Essex, P.a.
• Arati A Inamdar, MD/PHD
• Institute for Reproductive Medicine and Science at Saint Barnabas

• Family Nurse Practitioner in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.