Taliat Abiodun Fawole, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

33663 Issued in NE

Practice address

7901 Broadway
Elmhurst, NY 11373-1329

Phone

(718) 334-3542

NPI assigned

Apr 9, 2016

Last updated

Apr 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in NE, IN, TX3 enrollments

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 3

Specialty

Psychiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment Care Compare group NPD
• Alegent Creighton Health

  dba CHI Health

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1033288923

  Psychiatry

  Medicare reassignment NPD
• Charles Drew Health Center, Inc

  dba Charles Drew Health Center, Inc at Grant Street

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1255302170
  Medicare reassignment NPD
• Houston Methodist Specialty Physicians

  • Otolaryngology Physician
  • Houston, TX
  • NPI 1902614332
  Medicare reassignment
• TMH Physician Associates PLLC

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1275779225
  Medicare reassignment
• Alegent Creighton Health

  dba CHI Health

  • Community/Retail Pharmacy
  • Lincoln, NE
  • NPI 1598423220
  NPD
• Charles Drew Health Center, Inc.

  dba Charles Drew Health Center Inc at Benson SBHC

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1215767421
  NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD
• Alegent Health Immanuel Medical Center

  dba Alegent Health Immanuel Medical Center RTC

  • Psychiatric Residential Treatment Facility
  • Omaha, NE
  • NPI 1992964100
  NPD (past)
• Charles Drew Health Center Inc

  dba Charles Drew Health Center Inc Mobile Medical

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1386218212
  NPD (past)

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1255795886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 S Creasy LN",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4866",
            "fax_number": "765-502-4401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 Fannin St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "832-667-5301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWOLE",
        "first_name": "TALIAT",
        "middle_name": "ABIODUN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-09",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "33663",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01097670A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "FF6061092",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "FF6066383",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "FF6066383",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "W0805",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NE",
            "license": "33663",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Farraye, MD
• Farzana Matin, M.D., P.C.
• Evangelia Fatourou, MD
• Hossein Fattahi, MD, MS, MA
• Bolutife Fawole, MD
• Faye Grand, Otr CHT PC (Hand Therapy Center)
• Faye Grand, Otr CHT PC (Faye Grand Hand Therapy Center)
• Arsen Faylayev, PHARMD
• Federation of Organizations for the Ny State Mentally Disabled Inc
• Jill Brett Feffer, MD

• Psychiatry Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.

Verify at the official NPI Registry.