Individual provider Active NPI

Tunde Sunny Komolafe

  • Registered Nurse
  • Washington, DC
National Provider Identifier
1740786516
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN966631 Issued in DC
Practice address
4330 3Rd St NW
Washington, DC 20011-7316
Phone
(202) 415-0430
Fax
(301) 336-5640
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN966631 DC Primary

Addresses

Primary practice location

4330 3Rd St NW
Washington, DC 20011-7316

Mailing address

4330 3Rd St NW
Washington, DC 20011-7316
Phone (202) 415-0430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN966631DCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
TSK Healthcare Express LLC Current Accepting new patients
TSK Homes LLC Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1740786516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 3RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200117316",
            "telephone_number": "202-415-0430",
            "fax_number": "301-336-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 3RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200117316",
            "telephone_number": "202-415-0430",
            "fax_number": "301-336-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOLAFE",
        "first_name": "TUNDE",
        "middle_name": "SUNNY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN966631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.