Active NPI
Victor Adeola Olujimi, M.D.
- Sports Medicine (Orthopaedic Surgery) Physician
- Riverhead, NY
National Provider Identifier
1104069160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 284928-01
- Practice address
- 64 Commerce Drive
Riverhead, NY 11901-4455 - Phone
- (631) 369-5000
- NPI assigned
- Apr 7, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 084928-01 | NY | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 284928-01 | NY | Primary |
Addresses
Primary practice location
64 Commerce Drive
Riverhead, NY 11901-4455
Mailing address
64 Commerce Drive
Riverhead, NY 11901-4455
Phone (631) 369-5000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cora Health Services Inc
Practice addresses (Care Compare)
1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378
64 Commerce Ave
Riverhead, NY 11901-4455
Phone (631) 369-5000
Hospital & facility affiliations
- Peconic Bay Homehealth Services
- Peconic Bay Medical Center
- Suny/Stony Brook University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Knee replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 40 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084928-01 | NY | MD | Orthopaedic Surgery Physician |
| 284928-01 | NY | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peconic Bay Primary Medical Care | Current | Accepting new patients |
Locations
496 County Road 111
Bldg B
Manorville, NY 11949
Phone (631) 405-3200
64 Commerce Ave
Riverhead, NY 11901
Phone (631) 369-5000
34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- volujimi70436@northwell.direct-ci.com
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.
-
- Internal Medicine Physician
- Mattituck, NY
- NPI 1487620613
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Riverhead, NY
- NPI 1386649804
-
- Home Health Agency
- Riverhead, NY
- NPI 1932155678
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1104069160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 COMMERCE DRIVE",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119014455",
"telephone_number": "631-369-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 COMMERCE DRIVE",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119014455",
"telephone_number": "631-369-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUJIMI",
"first_name": "VICTOR",
"middle_name": "ADEOLA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-07",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NY",
"license": "084928-01",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "NY",
"license": "284928-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.