Individual provider Active NPI

Markson Ayeku

  • Licensed Practical Nurse
  • Springfield Gardens, NY
National Provider Identifier
1811307945
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
318297 Issued in NY
Practice address
22612 146TH Ave
Springfield Gardens, NY 11413-3815
Phone
(646) 657-7653
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 318297 NY Primary
Licensed Vocational Nurse 164X00000X 318297 NY
Nursing Care Agency 251J00000X 318297 NY

Addresses

Primary practice location

22612 146TH Ave
Springfield Gardens, NY 11413-3815

Mailing address

13 Cleveland St
Valley Stream, NY 11580-6003
Phone (516) 823-1569

Other identifiers 1

IdentifierTypeStateIssuer
890777960OtherNYEMPIRE PLAN

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
I20260216001668 NY Order and Referring Only - Nurse Practitioner 7416437835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
318297NYMDNursing Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1811307945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 CLEVELAND ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806003",
            "telephone_number": "516-823-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22612 146TH AVE",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114133815",
            "telephone_number": "646-657-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYEKU",
        "first_name": "MARKSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "318297",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "NY",
            "license": "318297",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "318297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE PLAN",
            "identifier": "890777960",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield Gardens, NY

Sources for this page

Verify at the official NPI Registry.