Individual provider Active NPI

Samson Kayode Olojede, PT,DPT

  • Physical Therapist
  • Rosedale, NY
National Provider Identifier
1598818569
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012797 Issued in NY
Practice address
23436 Merrick Blvd
Rosedale, NY 11422-1320
Phone
(718) 949-9400
Fax
(929) 250-1700
NPI assigned
Jan 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 012797 NY Primary

Addresses

Primary practice location

23436 Merrick Blvd
Rosedale, NY 11422-1320

Mailing address

251 Hungry Harbor Rd
Valley Stream, NY 11581-2804
Phone (516) 668-8210

Other names 1

  • Dr. Kayode Samson Olojede Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111018000018 NY Practitioner - Physical Therapist in Private Practice 0547432528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laurelton Heart Specialist PCGroup PAC ID 1355248030, 2 clinicians

Practice addresses (Care Compare)

23436 Merrick Blvd
Rosedale, NY 11422-1320
Phone (718) 949-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012797NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Laurelton Heart Specialist P.C. CurrentSince Jul 24, 2011 Accepting new patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Jan 24, 2024 Accepting new patients
Zion Health Solutions, LLC Past Accepting new patients

Locations

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

23436 Merrick Blvd
Rosedale, NY 11422
Phone (718) 949-9400

Organizations & group practices 3

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": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1598818569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 HUNGRY HARBOR RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115812804",
            "telephone_number": "516-668-8210",
            "fax_number": "516-569-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23436 MERRICK BLVD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114221320",
            "telephone_number": "718-949-9400",
            "fax_number": "929-250-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOJEDE",
        "first_name": "SAMSON",
        "middle_name": "KAYODE",
        "name_prefix": "Dr.",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYODE",
            "last_name": "OLOJEDE",
            "middle_name": "SAMSON",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.