Olasumbo Omowonuola Awoniyi, MD,MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA11326400 Issued in NJ

Practice address

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Phone

(201) 967-4000

NPI assigned

Mar 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Olasumbo Omowonuola Soyoola Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Bergen County Improvement Authority

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1891836441
  Medicare reassignment NPD
• Rutgers Health-RWJ Pediatric Critical Care

  • Family Medicine Physician
  • New Brunswick, NJ
  • NPI 1780766527
  Medicare reassignment NPD
• Bergen County Improvement Authority

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1952456295
  NPD
• Rutgers Health-RWJ Pediatric Critical Care

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • New Brunswick, NJ
  • NPI 1346322732
  NPD

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1073074969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWONIYI",
        "first_name": "OLASUMBO",
        "middle_name": "OMOWONUOLA",
        "name_prefix": "Dr.",
        "credential": "MD,MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA11326400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLASUMBO",
            "last_name": "SOYOOLA",
            "middle_name": "OMOWONUOLA",
            "prefix": "DR.",
            "credential": "MD,MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Erin Averill
• Christopher Jacob Awwad, D.O.
• Jessica Ayala, LCSW
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• Family Medicine Physician in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.