Active NPI
Esohe Agbonkpolor
- Licensed Practical Nurse
- Brooklyn, NY
National Provider Identifier
1891086062
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Jul 18, 2019.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 303350
- Practice address
- 2505 Tilden Ave
Brooklyn, NY 11226-5015 - Phone
- (718) 941-4490
- NPI assigned
- Apr 22, 2011
- Last updated
- Mar 21, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 303350 | NY | Primary |
Addresses
Primary practice location
2505 Tilden Ave
Brooklyn, NY 11226-5015
Mailing address
2505 Tilden Ave
Brooklyn, NY 11226-5015
Phone (718) 941-4490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303350 | NY | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1891086062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 TILDEN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112265015",
"telephone_number": "718-941-4490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 TILDEN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112265015",
"telephone_number": "718-941-4490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGBONKPOLOR",
"first_name": "ESOHE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-22",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "303350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.