Individual provider Active NPI

Mustapha Olatilewa

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1275394751
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
122258 Issued in NY
Practice address
112 Schermerhorn St
Brooklyn, NY 11201-5108
Phone
(718) 722-4727
NPI assigned
Jan 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 122258 NY Primary

Addresses

Primary practice location

112 Schermerhorn St
Brooklyn, NY 11201-5108

Mailing address

112 Schermerhorn St
Brooklyn, NY 11201-5108
Phone (718) 722-4727

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

State licenses

LicenseStateTypeSpecialty
122258NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1275394751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SCHERMERHORN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015108",
            "telephone_number": "718-722-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SCHERMERHORN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015108",
            "telephone_number": "718-722-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATILEWA",
        "first_name": "MUSTAPHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "122258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.