Bamidele Olawale Johnson

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D0104395 Issued in MD

Practice address

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Phone

(718) 613-4334

NPI assigned

Apr 18, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Bamidele Olawale Johnson Professional name

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: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1669969382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15005 HEALTH CENTER DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-613-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15005 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207161017",
            "country_code": "US",
            "telephone_number": "301-805-6070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BAMIDELE",
        "middle_name": "OLAWALE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0104395",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAMIDELE",
            "last_name": "JOHNSON",
            "middle_name": "OLAWALE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ariel Johnson, CDN
• Ashia Johnson
• Athena Johnson
• Ayana Aisha Johnson, LCSW
• Ayanna Johnson
• Bergelyn Johnson
• Bolarinwa Johnson
• Brianna Nicole Johnson, DO
• Bridgett Michelle Johnson, APRN
• Bridgette Johnson, LMSW

• Psychiatry Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.