Active NPI
Olawale S Oni, RPT
- Physical Therapist
- Bronx, NY
National Provider Identifier
1679635528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 015791
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019054178 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 015791 | NY | MD | Physical 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.