Individual provider Active NPI

Olawale S Oni, RPT

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1679635528
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015791 Issued in NY
Practice address
2G 3184 Grand Concourse
Bronx, NY 10458
Phone
(718) 365-1100
Fax
(718) 365-4344
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 015791 NY Primary

Addresses

Primary practice location

2G 3184 Grand Concourse
Bronx, NY 10458

Mailing address

2G 3184 Grand Concourse
Bronx, NY 10458
Phone (718) 365-1100

Other identifiers 1

IdentifierTypeStateIssuer
019054178MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000216 NY Practitioner - Physical Therapist in Private Practice 3870643091 Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015791NYMDPhysical Therapist

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679635528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2G 3184 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10458",
            "telephone_number": "718-365-1100",
            "fax_number": "718-365-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2G 3184 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10458",
            "telephone_number": "718-365-1100",
            "fax_number": "718-365-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONI",
        "first_name": "OLAWALE",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019054178",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.