Deborah Bolanle Famuyide, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R053768 Issued in NY

Practice address

2750 Atlantic Ave
Suite 100
Brooklyn, NY 11207-2811

Phone

(718) 647-6699

Fax

(718) 647-6777

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIAIAA
• Direct secure messaging: deborahfamuyide@sunydmc.allscriptsdirect.net

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.

• University Physicians of Brooklyn, Inc.

  • Child & Adolescent Psychiatry Physician
  • Brooklyn, NY
  • NPI 1689715476

  Clinical

  Medicare reassignment NPD
• Amazing Medical Services P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1417287905
  NPD (past)
• Feafea Moore Peal Nurse Practitioner in Family Health PLLC

  • Family Nurse Practitioner
  • Brooklyn, NY
  • NPI 1063921922
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1295806156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 ATLANTIC AVE",
            "address_2": "SUITE 100",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072811",
            "telephone_number": "718-647-6699",
            "fax_number": "718-647-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 ATLANTIC AVE",
            "address_2": "SUITE 100",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072811",
            "telephone_number": "718-647-6699",
            "fax_number": "718-647-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMUYIDE",
        "first_name": "DEBORAH",
        "middle_name": "BOLANLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11507",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R053768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1983848",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Services Network of New York Inc.
• Family Services of Greater New York LLC
• Family Social Adult Day Care
• Henrieta Famosaya, PT
• Paulina Famula, RN
• Chrystal Fan, FNP-C
• Linda Fan, MD
• Linlin Fan, LMSW
• Thieu P Fan
• Ye Fan

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.