Olasumbo Fadiya, RN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN261159 Issued in MA

Practice address

7 Cragmere Ter
Apt. #1
Mattapan, MA 02126-2508

Phone

(617) 407-5875

NPI assigned

Jan 26, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

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.

• Ipc Hospitalists of New England, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1659555266

  Adult Health

  Medicare reassignment NPD
• Massachusetts Acute Care Specialists PC

  • Internal Medicine Physician
  • Melrose, MA
  • NPI 1306134812
  Medicare reassignment NPD
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MA

  Medicare reassignment NPD
• Ipc Hospitalists of New England PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1801330287
  NPD

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1033656160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CRAGMERE TER",
            "address_2": "APT. #1",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262508",
            "telephone_number": "617-407-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CRAGMERE TER",
            "address_2": "APT. #1",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262508",
            "telephone_number": "617-407-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADIYA",
        "first_name": "OLASUMBO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN261159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Dongwon Kim PC
• Althea Lorraine Drew
• El Shaddai Dental Associates Mattapan PC
• Kyesha Chaunte Elliott
• Edith Estrada Juhlin, APRN-BC
• Fabyola Tamarah Faublas
• Danielle Jane Fearon, LMHC
• Thomas Fiese
• Elizabeth Fitzgerald
• Tiniya Fulks

• Adult Health Nurse Practitioner in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.