Individual provider Active NPI

Grace Ojuolape Feyijinmi

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1255859393
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024195 Issued in NY
Practice address
99 Wall St Ste 1461
New York, NY 10005-4301
Phone
(347) 559-0299
NPI assigned
Sep 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 024195 NY Primary

Addresses

Primary practice location

99 Wall St Ste 1461
New York, NY 10005-4301

Mailing address

99 Wall St Ste 1461
New York, NY 10005-4301

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428000552 NY Order and Referring Only - Clinical Psychologist 7214453893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024195NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Heights Psychological Services, PLLC Clinical Current Accepting new patients
New Heights Psychological Services, PLLC Clinical Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1255859393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WALL ST STE 1461",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 WALL ST STE 1461",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054301",
            "telephone_number": "347-559-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEYIJINMI",
        "first_name": "GRACE",
        "middle_name": "OJUOLAPE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.