Organization Active NPI

Olukayode a Oladeji MD LLC

  • Cardiovascular Disease Physician
  • East Brunswick, NJ
National Provider Identifier
1447658281
Registry record updated May 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA06383900 Issued in NJ
Legal business name
OLUKAYODE A OLADEJI MD LLC
Practice address
1 Race Track Rd
Suite A101
East Brunswick, NJ 08816-3870
Phone
(732) 238-8090
Fax
(732) 238-8091
NPI assigned
Dec 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2015

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

Authorized official

Name
Olukayode Oladeji, MDNPI 1376579086
Title
Owner
Phone
(732) 238-8090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 25MA06383900 NJ Primary

Addresses

Primary practice location

1 Race Track Rd
Suite A101
East Brunswick, NJ 08816-3870

Mailing address

PO Box 696
Old Bridge, NJ 08857-0696
Phone (732) 238-8090

Other identifiers 2

IdentifierTypeStateIssuer
891991ZL2AOtherNJMEDICARE ID-TYPE UNSPECIFIED
7067909MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150130000245 NJ Part B Supplier - Clinic/Group Practice 5597089110 Receives reassigned benefits from 1 practitioner
Practice locations: East Brunswick, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430611200000",
    "number": "1447658281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088570696",
            "telephone_number": "732-238-8090",
            "fax_number": "732-238-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RACE TRACK RD",
            "address_2": "SUITE A101",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163870",
            "telephone_number": "732-238-8090",
            "fax_number": "732-238-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLUKAYODE A OLADEJI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2015-05-03",
        "status": "A",
        "authorized_official_last_name": "OLADEJI",
        "authorized_official_first_name": "OLUKAYODE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-238-8090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA06383900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "891991ZL2A",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7067909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.