Individual provider Active NPI

Bola Ladeji-Kuku

  • Family Nurse Practitioner
  • East Orange, NJ
National Provider Identifier
1639015340
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NR12589900 Issued in NJ
Practice address
79 Stockton PL
East Orange, NJ 07017-5208
Phone
(201) 301-4388
NPI assigned
Apr 25, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F359689 NY
Family Nurse Practitioner 363LF0000X 26NR12589900 NJ Primary

Addresses

Primary practice location

79 Stockton PL
East Orange, NJ 07017-5208

Mailing address

79 Stockton PL
East Orange, NJ 07017-5208
Phone (201) 301-4388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5401

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F359689NYMDNurse Practitioner
26NR12589900NJMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1777075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1639015340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 STOCKTON PL",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070175208",
            "telephone_number": "201-301-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 STOCKTON PL",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070175208",
            "telephone_number": "201-301-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADEJI-KUKU",
        "first_name": "BOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-25",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F359689",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NR12589900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.