Individual provider Active NPI

Fatima Olude, AGNP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1740707975
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308375 Issued in NY
Practice address
902 Drew St Apt 109
Brooklyn, NY 11208-5154
Phone
(917) 753-0899
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308375 NY Primary

Addresses

Primary practice location

902 Drew St Apt 109
Brooklyn, NY 11208-5154

Mailing address

902 Drew St Apt 109
Brooklyn, NY 11208-5154
Phone (917) 753-0899

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180320001101 NY Practitioner - Nurse Practitioner 3870855406 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
308375NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Mar 1, 2020 Accepting new patients
Jerry Uduevbo, M.D., P.C. CurrentSince Jan 27, 2018 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 1, 2020 Accepting new patients
Ion Oltean Physician PC CurrentSince Jul 22, 2018 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Rd Medical Professional Services PC CurrentSince Aug 10, 2022 Accepting new patients

Locations

1050 E 230th St
Bronx, NY 10466
Phone (718) 654-5875

594 Albany Ave
Brooklyn, NY 11203
Phone (646) 694-6680

50 Water St
Fl 3
New York, NY 10004

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740707975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 DREW ST APT 109",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085154",
            "telephone_number": "917-753-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 DREW ST APT 109",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085154",
            "telephone_number": "917-753-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUDE",
        "first_name": "FATIMA",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.