Individual provider Active NPI

Oluwole Oluyinka Oluyemi Konigbagbe, MBBS

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1558089342
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301517155 Issued in MI
Practice address
111 E 210TH St
Bronx, NY 10467-2490
Phone
(718) 920-5731
NPI assigned
Aug 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 4301517155 MI Primary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X P115301 NY

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2490

Mailing address

1 Newbury CT
North Haven, CT 06473-3287
Phone (860) 265-9619

Other practice location 1

330 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1267
Phone (616) 752-6235

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ConnectUrl Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4301517155MIMDNephrology Physician
P115301NYMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1558089342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NEWBURY CT",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733287",
            "telephone_number": "860-265-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672490",
            "telephone_number": "718-920-5731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 E Beltline Ave NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495061267",
            "country_code": "US",
            "telephone_number": "616-752-6235",
            "fax_number": "616-752-6324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONIGBAGBE",
        "first_name": "OLUWOLE",
        "middle_name": "OLUYINKA OLUYEMI",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-17",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301517155",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "P115301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ConnectUrl",
            "affiliation": "N",
            "endpointDescription": "ConnectUrl",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ConnectUrl",
            "address_1": "140 Saint Edwards St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112013904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 8, 2026; 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.