Active NPI
Oluwole Oluyinka Oluyemi Konigbagbe, MBBS
- Nephrology Physician
- Bronx, NY
National Provider Identifier
1558089342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 4301517155
- 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
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 4301517155 | MI | Primary |
| Nephrology Physician | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4301517155 | MI | MD | Nephrology Physician |
| P115301 | NY | MD | Nephrology 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.