Individual provider Active NPI

Folasade Ajisegbede, CRNA

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1740747971
Registry record updated Jul 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
133994 Issued in NY
Practice address
560 West 168TH St
New York, NY 10032-3917
Phone
(917) 754-4316
NPI assigned
Feb 24, 2019
Last updated
Jul 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 133994 NY Primary
Critical Care Medicine Registered Nurse 163WC0200X 679155 NY

Addresses

Primary practice location

560 West 168TH St
New York, NY 10032-3917

Mailing address

8704 Farragut Rd
Brooklyn, NY 11236-3237

Other names 1

  • Folasade Ajibade Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201228000384 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395157986 Reassigns benefits to 2 organizations
I20220404000679 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395157986 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians
Parkway Anesthesia Associates LLCGroup PAC ID 2567758931, 313 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
Robert Wood Johnson University Hosp
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

10 Plum St
New Brunswick, NJ 08901-2065
Phone (732) 937-8841

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9292

65 James St
Edison, NJ 08820-3947
Phone (201) 854-5000

99 Hwy 37 W
Toms River, NJ 08755-6423
Phone (732) 557-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
679155NYMDCritical Care Medicine Registered Nurse
133994NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Single Specialty CurrentSince Mar 24, 2024 Accepting new patients
New Jersey Healthcare Specialists PC Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care Single Specialty CurrentSince May 16, 2022 Accepting new patients
Parkway Anesthesia Associates LLC Single Specialty CurrentSince Feb 8, 2022 Accepting new patients
Rwjbh Observation Associates LLC Single Specialty CurrentSince Jul 16, 2022 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care Single Specialty CurrentSince May 16, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 24, 2024 Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

10 Plum St
#G
New Brunswick, NJ 08901
Phone (732) 937-8841

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

66 W Gilbert St
Ste 100
Tinton Falls, NJ 07701
Phone (201) 795-8637

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Networks

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

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1550966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656892800000",
    "number": "1740747971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8704 FARRAGUT RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 WEST 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323917",
            "telephone_number": "917-754-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJISEGBEDE",
        "first_name": "FOLASADE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-24",
        "last_updated": "2022-07-04",
        "certification_date": "2022-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "133994",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "679155",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FOLASADE",
            "last_name": "AJIBADE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.