Olubunmi Abiye Bolaji, M.D.

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

254613 Issued in NY

Practice address

6080 Jericho Tpke Ste 205
Commack, NY 11725-2808

Phone

(631) 486-4834

Fax

(631) 486-5029

NPI assigned

Aug 25, 2009

Last updated

May 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• Woodbury Heights Nursing and Rehabilitation Center Nursing home, Woodbury, NY, CCN 335555

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primerose Medical P.C.

  • Primary Care Clinic/Center
  • Levittown, NY
  • NPI 1699103721
  Medicare reassignment Authorized official
• New York General Medical Services PC

  • Hospitalist Physician
  • New York, NY
  • NPI 1700315538
  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  NY

  Medicare reassignment NPD
• Cogent Medical Care PC

  • Internal Medicine Physician
  • East Patchogue, NY
  • NPI 1912941238
  Medicare reassignment
• Comprehensive Island Medical Care LLC

  • Internal Medicine Physician
  • Commack, NY
  • NPI 1154435576
  NPD
• Cold Spring Acquisition LLC

  • Skilled Nursing Facility
  • Woodbury, NY
  • NPI 1477909638
  NPD (past)
• The Rosalind and Joseph Gurwin Jewish Geriatric Center of Long Island

  • Skilled Nursing Facility
  • Commack, NY
  • NPI 1669472304
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cold Spring Acquisition LLC

  • Skilled Nursing Facility
  • Woodbury, NY
  • NPI 1477909638

  Nursing home

  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1619100633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252808",
            "telephone_number": "631-486-4834",
            "fax_number": "631-486-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252808",
            "telephone_number": "631-486-4834",
            "fax_number": "631-486-5029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13124 Rockaway Blvd",
            "address_purpose": "LOCATION",
            "city": "South Ozone Park",
            "state": "NY",
            "postal_code": "114202932",
            "country_code": "US",
            "telephone_number": "718-322-7583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLAJI",
        "first_name": "OLUBUNMI",
        "middle_name": "ABIYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "254613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03203005",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy A. Bloom, RN
• Kelly Jean Blum, NP
• Mark J Bluth, MD
• Jeffrey Stuart Blye, D.D.S.
• Viktoria Bogdasarova
• Katherine Alexandrea Bollman
• Christopher Bondoc, MD
• Jessica Boney
• Justine Bonilla
• Kristin Bonura

• Hospice and Palliative Medicine (Internal Medicine) Physician in Commack, NY
• Providers in Commack, NY by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.
• 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.