NPIMap

Individual provider Active NPI

Olaide Israel Ayegbusi

  • Pharmacist
  • Jessup, MD
National Provider Identifier
1154978328
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26738 Issued in MD
Practice address
7650 Port Capital Dr
Jessup, MD 20794-6793
Phone
(410) 799-7770
NPI assigned
Aug 22, 2019
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26738 MD Primary

Addresses

Primary practice location

7650 Port Capital Dr
Jessup, MD 20794-6793

Mailing address

929 Montgomery St Apt B
Laurel, MD 20707-3427
Phone (240) 360-7941

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL www.cvs.com Direct
Direct Messaging Address frederick.galzarano@cvshealth.com Direct
Other URL www.cvs.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

Practice roles

OrganizationSpecialtyStatusNew patients
Hil Pharmacy, LLC Current Accepting new patients
Hil Pharmacy, LLC Pharmacist Current Accepting new patients
Maryland CVS Pharmacy, L.L.C. PastSince Aug 25, 2019 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1154978328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 MONTGOMERY ST APT B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073427",
            "telephone_number": "240-360-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 PORT CAPITAL DR",
            "city": "JESSUP",
            "state": "MD",
            "postal_code": "207946793",
            "telephone_number": "410-799-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYEGBUSI",
        "first_name": "OLAIDE",
        "middle_name": "ISRAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "26738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.cvs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "CVS Pharmacy",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "CVS",
            "address_1": "929 Montgomery St Apt B",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207073427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frederick.galzarano@cvshealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7650 Port Capital Dr",
            "city": "Jessup",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207946793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.cvs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "CVS Pharmacy",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "CVS",
            "address_1": "929 Montgomery St Apt B",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207073427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jessup, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.