Active NPI
Cityblock Medical Practice Ma, PC
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1407493455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 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 DirectoryNPI 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.