Organization Active NPI

Cityblock Medical Practice Ma, PC

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1407493455
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CITYBLOCK MEDICAL PRACTICE MA, PC
Practice address
155 Federal St Ste 700
Boston, MA 02110-1727
Phone
(000) 000-0000
NPI assigned
Dec 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Oluwatoyin Ajayi, MD
Title
President
Phone
(844) 692-5625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

155 Federal St Ste 700
Boston, MA 02110-1727

Mailing address

55 Water St # 4C
Brooklyn, NY 11201-1052

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1407493455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST # 4C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 FEDERAL ST STE 700",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101727",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITYBLOCK MEDICAL PRACTICE MA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-09",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "OLUWATOYIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-692-5625",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.