Active NPI
Adeniyi Adedayo Olabumuyi, MBBS
- Student in an Organized Health Care Education/Training Program
- Brooklyn, NY
National Provider Identifier
1477296242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 760 Broadway
Brooklyn, NY 11206 - Phone
- (718) 963-8752
- Fax
- (718) 953-8753
- NPI assigned
- Apr 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
760 Broadway
Brooklyn, NY 11206
Mailing address
66 Wintergreen TRL
The Woodlands, TX 77382
Phone (469) 837-9512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670544000000",
"number": "1477296242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 WINTERGREEN TRL",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "77382",
"telephone_number": "469-837-9512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11206",
"telephone_number": "718-963-8752",
"fax_number": "718-953-8753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLABUMUYI",
"first_name": "ADENIYI",
"middle_name": "ADEDAYO",
"credential": "MBBS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-19",
"last_updated": "2022-12-09",
"certification_date": "2022-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.