Individual provider Active NPI

Ekundayo Mujaid Sunmonu

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1942514955
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
298888-1 Issued in NY
Practice address
1085 Washington Ave
Apt 2H
Bronx, NY 10456-6669
Phone
(347) 304-3265
NPI assigned
Aug 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 298888-1 NY Primary

Addresses

Primary practice location

1085 Washington Ave
Apt 2H
Bronx, NY 10456-6669

Mailing address

1085 Washington Ave
Apt 2H
Bronx, NY 10456-6669
Phone (347) 304-3265

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
I20221017001708 NY Practitioner - Nurse Practitioner 3577939594 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
298888-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 1, 2023 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

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

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: esunmonu1175675@nychhc.direct-ci.com

Organizations & group practices 3

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": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1942514955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 WASHINGTON AVE",
            "address_2": "APT 2H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104566669",
            "telephone_number": "347-304-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 WASHINGTON AVE",
            "address_2": "APT 2H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104566669",
            "telephone_number": "347-304-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNMONU",
        "first_name": "EKUNDAYO",
        "middle_name": "MUJAID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "298888-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.