Individual provider Active NPI

Olubunmi B Sasona

  • Community Health Worker
  • Bloomfield, NJ
National Provider Identifier
1053077156
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
125 Hoover Ave
Bloomfield, NJ 07003-3858
Phone
(862) 333-6400
Fax
(908) 248-8234
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 123 NJ
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

125 Hoover Ave
Bloomfield, NJ 07003-3858

Mailing address

125 Hoover Ave
Bloomfield, NJ 07003-3858
Phone (862) 333-6400

Other identifiers 1

IdentifierTypeStateIssuer
NONEMedicaidNJ

Electronic endpoints 4

TypeEndpointUseAffiliation
CONNECT URL PKHANDSBLESSED@AOL.COM Direct
CONNECT URL PKHANDSBLESSED@AOL.COM Health Information Exchange (HIE)
CONNECT URL DELETRAVAL@GMAIL.COM Direct
CONNECT URL DELETRAVAL@GMAIL.COM Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1053077156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HOOVER AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033858",
            "telephone_number": "862-333-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HOOVER AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033858",
            "telephone_number": "862-333-6400",
            "fax_number": "908-248-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASONA",
        "first_name": "OLUBUNMI",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NJ",
            "license": "123",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PKHANDSBLESSED@AOL.COM",
            "affiliation": "N",
            "endpointDescription": "HOME/OFFICE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Maple Ave",
            "city": "Montclair",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070424549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PKHANDSBLESSED@AOL.COM",
            "affiliation": "N",
            "endpointDescription": "HOME/ OFFICE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Maple Ave",
            "city": "Montclair",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070424549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DELETRAVAL@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "SASSONA E-MAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "125 Hoover Ave",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070033858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DELETRAVAL@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "125 HOOVER AVENUE, BLOOMFIELD, NJ 07003",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MEDICAL RECORDS",
            "address_1": "125 Hoover Ave",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070033858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.