Individual provider Active NPI

Oladele B Oluwakuyide, B.SC PHYSICAL THERAP

  • Physical Therapist
  • Union, NJ
National Provider Identifier
1467518696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QAO835800 Issued in NJ
Practice address
1119 Weber St
Union, NJ 07083-5826
Phone
(646) 894-9367
Fax
(908) 688-9367
NPI assigned
Dec 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QAO835800 NJ Primary
Physical Therapist 225100000X 0186861 NY

Addresses

Primary practice location

1119 Weber St
Union, NJ 07083-5826

Mailing address

1119 Weber St
Union, NJ 07083-5826
Phone (646) 894-9367

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

State licenses

LicenseStateTypeSpecialty
40QAO835800NJMDPhysical Therapist
0186861NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gohewec Healthcare Providers Past Accepting new patients
Gohewec Physio-Med Link, Inc. Physical Therapist PastSince Jun 30, 2002 Accepting new patients

Organizations & group practices 2

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": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467518696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 WEBER ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835826",
            "telephone_number": "646-894-9367",
            "fax_number": "908-688-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 WEBER ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835826",
            "telephone_number": "646-894-9367",
            "fax_number": "908-688-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUWAKUYIDE",
        "first_name": "OLADELE",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "B.SC PHYSICAL THERAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QAO835800",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0186861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.