Olanrewaju Adeosun, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

203510 Issued in NY

Practice address

1711 Ralph Ave
Brooklyn, NY 11236-3319

Phone

(347) 276-6234

Fax

(718) 649-6357

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Colleen Henry Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1962451195
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1174648489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11236",
            "telephone_number": "347-276-6234",
            "fax_number": "718-649-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363319",
            "telephone_number": "347-276-6234",
            "fax_number": "718-649-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEOSUN",
        "first_name": "OLANREWAJU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "203510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01729900",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2506487",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "OH351",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "HENRY",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Oluwabunmi Adenowo
• Adedeji Adenusi, MBCHB
• Adeola R. Uthman. M.D.,P.C.
• Oluranti Adeoshun
• Ibijoke Adeosun, N.P.
• Oyekanmi Emmanuel Adepoju
• Terrell Adepoju, LMSW
• Moses Adekunle Aderanti, M.D
• Victoria Aderin
• Laura Mary Catherine Ades, M.D.

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.