Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bamidele Omowumi Agada, NURSEPRACTITIONER

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1467921122

Bamidele Omowumi Agada, NURSEPRACTITIONER is a Nurse Practitioner in Laurelton, New York. Graduated from Birmingham Medical College in 2023, 3 years ago. Practices with St John's Medical Services PC, a 86-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Trained at
Birmingham Medical College
Licensed in
NY
In the registry since
2018
Specialties on file
2

Practice location Address checks out

13528 231st St
Laurelton, NY 11413-2532
Phone: (646) 331-9356
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence F405177 (NY)
General Practice Registered Nurse Taxonomy 163WG0000X · Licence 569577-1 (NY)

Record details

NPI number1467921122
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedNovember 24, 2018
Last updated in NPPESFebruary 2, 2024
Certification dateFebruary 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolBIRMINGHAM MEDICAL COLLEGE
Graduated 2023 (3 years in practice)
Group practice St John'S Medical Services Pc — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Laurelton