Individual provider Active NPI

Edith Afulenu Obi, FNP-BC

  • Family Nurse Practitioner
  • Laurelton, NY
National Provider Identifier
1780570077
Registry record updated Jun 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335493 Issued in NY
Practice address
13816 228TH St
Laurelton, NY 11413-2843
Phone
(917) 459-8777
NPI assigned
Jun 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 335493 NY Primary

Addresses

Primary practice location

13816 228TH St
Laurelton, NY 11413-2843

Mailing address

13816 228TH St
Laurelton, NY 11413-2843
Phone (917) 459-8777

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
I20251105002395 NY Practitioner - Nurse Practitioner 1254821523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

397 Little Neck Rd
3300 South BLDG. 300
Virginia Beach, VA 23452-7327

PO Box
Suite 751
Pomona, NY 10970

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
335493NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Health PC CurrentSince Sep 15, 2025 Accepting new patients

Locations

33 Downtown Dr
Fl 3
Monsey, NY 10952
Phone (201) 357-1520

15 Monsey Blvd
Monsey, NY 10952
Phone (845) 356-3400

Organizations & group practices 1

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": "1749859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1780570077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13816 228TH ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132843",
            "telephone_number": "917-459-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13816 228TH ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132843",
            "telephone_number": "917-459-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBI",
        "first_name": "EDITH",
        "middle_name": "AFULENU",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-14",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurelton, NY

Sources for this page

Verify at the official NPI Registry.