Individual provider Active NPI

Bolanle Olajumoke Bello, N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1013160613
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401162-1 Issued in NY
Practice address
4401 Bronx Blvd
Bronx, NY 10470-1407
Phone
(718) 304-7000
Fax
(718) 304-9217
NPI assigned
Oct 28, 2008
Last updated
Oct 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401162-1 NY Primary

Addresses

Primary practice location

4401 Bronx Blvd
Bronx, NY 10470-1407

Mailing address

4401 Bronx Blvd
Bronx, NY 10470-1407
Phone (718) 304-7000

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
I20140908002373 NY Practitioner - Nurse Practitioner 2163641093 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service League IncGroup PAC ID 4284524448, 47 clinicians

Practice addresses (Care Compare)

25751 149TH Rd
Rosedale, NY 11422-3022

790 Park Ave
Huntington, NY 11743-4516
Phone (631) 427-3700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F401162-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Neuropsychiatric Services Psychiatric/Mental Health CurrentSince Jan 1, 2019 Accepting new patients
Sus Mental Health Programs, Inc. CurrentSince Feb 3, 2014 Accepting new patients
Family Service League, Inc. CurrentSince Dec 5, 2016 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Jul 14, 2014 Accepting new patients
Flushing Hospital Medical Center CurrentSince Jul 14, 2014 Accepting new patients
Nys Office of Mental Health CurrentSince Oct 28, 2015 Accepting new patients

Locations

1125 Fulton St
Ste 2
Brooklyn, NY 11238
Phone (347) 226-9025

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

463 Fashion Ave
Fl 17
New York, NY 10018
Phone 64656558165816

998 Crooked Hill Rd
West Brentwood, NY 11717
Phone (631) 306-5732

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1013160613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 BRONX BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701407",
            "telephone_number": "718-304-7000",
            "fax_number": "718-304-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 BRONX BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701407",
            "telephone_number": "718-304-7000",
            "fax_number": "718-304-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLO",
        "first_name": "BOLANLE",
        "middle_name": "OLAJUMOKE",
        "name_prefix": "Mrs.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401162-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.