Individual provider Active NPI

Olasunkanmi Bhadmus

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1417263328
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307489-1 Issued in NY
Practice address
506 6TH St
Brooklyn, NY 11215-3609
Phone
(718) 780-3767
Fax
(718) 780-3081
NPI assigned
Aug 30, 2010
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 573342 NY
Adult Health Nurse Practitioner 363LA2200X F307489-1 NY Primary
Gerontology Nurse Practitioner 363LG0600X F307489-1 NY
Adult Health Clinical Nurse Specialist 364SA2200X F307489-1 NY

Addresses

Primary practice location

506 6TH St
Brooklyn, NY 11215-3609

Mailing address

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-3767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160830003217 NY Practitioner - Nurse Practitioner 5597051508 Reassigns benefits to 2 organizations
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
O.B. Adult Health Nurse Practitioner Services PCGroup PAC ID 4880948553, 2 clinicians

Practice addresses (Care Compare)

1326 Clove Rd
Staten Island, NY 10301-4343

979 Bay St
Suite 3
Staten Island, NY 10305-4903
Phone (917) 830-1838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
573342NYMDSchool Registered Nurse
F307489-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamid Lalani Medical PLLC CurrentSince Jan 1, 2022 Accepting new patients
Jal 28 LLC Past Accepting new patients
Mermaid Management Inc PastSince Jun 30, 2016 Accepting new patients

Locations

228 Montrose Ave
Brooklyn, NY 11206
Phone (718) 284-7070

4713 Church Ave
Brooklyn, NY 11203
Phone (631) 760-1932

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1417263328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3767",
            "fax_number": "718-780-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3767",
            "fax_number": "718-780-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHADMUS",
        "first_name": "OLASUNKANMI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-30",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "573342",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307489-1",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F307489-1",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NY",
            "license": "F307489-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.