Individual provider Active NPI

Ayodeji Bodunrin Fayemi

  • Diagnostic Radiology Physician
  • Bronx, NY
National Provider Identifier
1295974905
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
119113 Issued in NY
Practice address
234 E 149TH St
Radiology Department-2C 3, Lincoln Hospital
Bronx, NY 10451-5504
Phone
(718) 579-5579
Fax
(718) 579-4649
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 119113 NY Primary

Addresses

Primary practice location

234 E 149TH St
Radiology Department-2C 3, Lincoln Hospital
Bronx, NY 10451-5504

Mailing address

234 E 149TH St
Radiology Department-2C 3, Lincoln Hospital
Bronx, NY 10451-5504
Phone (718) 579-5579

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
119113NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lincon Medical and Mental Center Diagnostic Radiology Past Accepting new patients

Organizations & group practices 1

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": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1295974905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "RADIOLOGY DEPARTMENT-2C 3, LINCOLN HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5579",
            "fax_number": "718-579-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "RADIOLOGY DEPARTMENT-2C 3, LINCOLN HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5579",
            "fax_number": "718-579-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYEMI",
        "first_name": "AYODEJI",
        "middle_name": "BODUNRIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "119113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.