Olalekan Graham Olatunji, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056011562 Issued in IL

Practice address

631 Hazel St
Oshkosh, WI 54901-4600

Phone

(715) 229-3008

NPI assigned

Mar 19, 2024

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  IL, Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Oasis Therapy Services LLC

  • Multi-Specialty Clinic/Center
  • Oshkosh, WI
  • NPI 1386381598

  IL, Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1790545606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 HAZEL ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 HAZEL ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014600",
            "telephone_number": "715-229-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATUNJI",
        "first_name": "OLALEKAN",
        "middle_name": "GRAHAM",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsie R Oestreich
• Shelley Offermann, RN
• Brandon Ohlrich
• Kingston Okrah, MD
• Omoruyi Okundaye
• Michael Olig
• Candice Oliphant, P.T.
• Shannon Olk
• Joseph Edward Olsen, D.M.D.
• Richard W Olsen, DDS

• Occupational Therapist in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.