Individual provider Active NPI

Christianah Yetunde Ogunlesi, MD

  • Psychiatry Physician
  • Bellerose, NY
National Provider Identifier
1063507358
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
49792 Issued in WI
Practice address
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Phone
(718) 264-4500
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 49792 WI Primary

Addresses

Primary practice location

7403 Commonwealth Blvd
Bellerose, NY 11426-1839

Mailing address

7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Phone (718) 264-4500

Other names 1

  • Yetunde Olukemi Ogunlesi Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170713002660 NY Practitioner - Psychiatry 1850398447 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49792WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Psychiatry Services, P.C. Psychiatry CurrentSince Apr 30, 2017 Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1063507358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7403 COMMONWEALTH BLVD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261839",
            "telephone_number": "718-264-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7403 COMMONWEALTH BLVD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261839",
            "telephone_number": "718-264-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNLESI",
        "first_name": "CHRISTIANAH",
        "middle_name": "YETUNDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "49792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YETUNDE",
            "last_name": "OGUNLESI",
            "middle_name": "OLUKEMI",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bellerose, NY

Sources for this page

Verify at the official NPI Registry.