Individual provider Active NPI

Olatunde Ola, MD, MPH

  • Student in an Organized Health Care Education/Training Program
  • Bridgeport, CT
National Provider Identifier
1255748828
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
84761 Issued in CT
Practice address
Yale New Haven Health, 267 Grant Street, Med Ed Podium4
Bridgeport, CT 06610-0120
Phone
(203) 384-4442
NPI assigned
Jul 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 84761 CT Primary

Addresses

Primary practice location

Yale New Haven Health, 267 Grant Street, Med Ed Podium4
Bridgeport, CT 06610-0120

Mailing address

Yale New Haven Health 267 Grant Street, Med Ed Podium 4
Bridgeport, CT 06610-0120
Phone (203) 384-4442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20260519001892 CT Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 2860762838

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84761CTMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255748828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "YALE NEW HAVEN HEALTH 267 GRANT STREET, MED ED PODIUM 4",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066100120",
            "telephone_number": "203-384-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "YALE NEW HAVEN HEALTH, 267 GRANT STREET, MED ED PODIUM4",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066100120",
            "telephone_number": "203-384-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLA",
        "first_name": "OLATUNDE",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-16",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "84761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.