Active NPI
Anthony Akinloye Olokungbemi, DPT
- Physical Therapist
- Bronx, NY
National Provider Identifier
1508910340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 015375
- Practice address
- 4626 White Plains Rd
Bronx, NY 10470-1610 - Phone
- (718) 324-8166
- Fax
- (718) 324-7539
- NPI assigned
- Jan 22, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 015375 | NY | Primary |
| Physical Therapist | 225100000X | 2666 | DC |
Addresses
Primary practice location
4626 White Plains Rd
Bronx, NY 10470-1610
Mailing address
PO Box 1031
Lodi, NJ 07644-7031
Phone (718) 324-8166
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 223702012 | Other | NY | FIRST HEALTH |
| 660533 | Other | NY | GHI PPO |
| 121300P | Other | NY | HIP |
| 228870 | Other | NY | WELLCARE |
| 223702012 | Other | NY | MPN |
| QP768 | Other | NY | BLUE CROSS BLUE SHIELD |
| 000000073981-B | Other | NY | GHI HMO |
| 2292361 | Other | NY | UNITED HEALTH CARE |
| 6202200 | Other | NY | CIGNA |
| P00288313 | Other | NY | RAILROAD MEDICARE |
| 01701817 | Medicaid | NY | |
| 05714G | Other | NY | GHI MEDICARE |
| 105663900 | Other | NY | DEPT. OF LABOR |
| 223702012 | Other | NY | HORIZON |
| P-11231046 | Other | NY | MULTIPLAN |
| PRISM NETWORK | Other | NY | 223702012-01 |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2666 | DC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1508910340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1031",
"city": "LODI",
"state": "NJ",
"postal_code": "076447031",
"telephone_number": "718-324-8166",
"fax_number": "718-324-7539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4626 WHITE PLAINS RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104701610",
"telephone_number": "718-324-8166",
"fax_number": "718-324-7539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLOKUNGBEMI",
"first_name": "ANTHONY",
"middle_name": "AKINLOYE",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "015375",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "2666",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "223702012",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PPO",
"identifier": "660533",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "121300P",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "228870",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MPN",
"identifier": "223702012",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "QP768",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI HMO",
"identifier": "000000073981-B",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "2292361",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6202200",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00288313",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01701817",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI MEDICARE",
"identifier": "05714G",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR",
"identifier": "105663900",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON",
"identifier": "223702012",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "P-11231046",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "223702012-01",
"identifier": "PRISM NETWORK",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.