Active NPI
Olatubosun Emmanuel Jewoola
- Behavior Analyst
- Jamaica, NY
National Provider Identifier
1295385458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 15408 134TH Ave
Jamaica, NY 11434-3610 - Phone
- (347) 840-0636
- NPI assigned
- Sep 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
15408 134TH Ave
Jamaica, NY 11434-3610
Mailing address
15408 134TH Ave
Jamaica, NY 11434-3610
Phone (347) 840-0636
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | desktop | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568764800000",
"number": "1295385458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15408 134TH AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114343610",
"telephone_number": "347-840-0636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15408 134TH AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114343610",
"telephone_number": "347-840-0636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWOOLA",
"first_name": "OLATUBOSUN",
"middle_name": "EMMANUEL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-18",
"last_updated": "2019-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "desktop",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "15408 134th Ave",
"city": "Jamaica",
"state": "NY",
"country_code": "US",
"postal_code": "114343610",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.