Individual provider Active NPI

Oluwatoyin T Ajayi, MBBS

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1790912426
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
292657 Issued in NY
Practice address
546 Eastern Pkwy
Brooklyn, NY 11225-1604
Phone
(833) 904-2273
Fax
(617) 414-2090
NPI assigned
Jun 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 62179 CT
Family Medicine Physician 207Q00000X 250701 MA
Family Medicine Physician 207Q00000X 2019-01142 NC
Family Medicine Physician 207Q00000X 292657 NY Primary

Addresses

Primary practice location

546 Eastern Pkwy
Brooklyn, NY 11225-1604

Mailing address

495 Flatbush Ave # C5
Brooklyn, NY 11225-3706

Other identifiers 1

IdentifierTypeStateIssuer
110093419AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY, NC, IN, OH, IL, FL, MI8 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
I20120921000562 MA Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization
I20180709001208 NY Practitioner - Family Practice 7517115298 Reassigns benefits to 2 organizations
I20191001001054 NC Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization
I20220712001146 IN Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization
I20220915000744 OH Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization
I20240117002587 IL Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization
I20240123002931 FL Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization
I20250130000958 MI Practitioner - Family Practice 7517115298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62179CTMDFamily Medicine Physician
250701MAMDFamily Medicine Physician
2019-01142NCMDFamily Medicine Physician
292657NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cityblock Ipa Ny, LLC CurrentSince Dec 14, 2025 Accepting new patients
Cityblock Medical Practice, LLC CurrentSince Oct 13, 2021 Accepting new patients
Oluwatoyin Ajayi Medical Practice, PC Family Medicine CurrentSince Aug 15, 2023 Accepting new patients
Advantagecare Physicians PC Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Advantagecare Physicians PC CurrentSince Jul 1, 2018 Accepting new patients
Cityblock Medical Practice, P.a. Family Medicine CurrentSince Jan 14, 2020 Accepting new patients
Cityblock Medical Practice, P.a. Past Accepting new patients
Fanourios I. Ferderigos, M.D., P.a. Past Accepting new patients

Locations

2626 Tampa Rd
Ste 103
Palm Harbor, FL 34684
Phone (727) 789-3300

15416 N Florida Ave
Ste 203
Tampa, FL 33613
Phone (347) 463-5529

16115 La Salle St
South Holland, IL 60473
Phone (347) 463-5529

100 Grove St
Ste 115
Worcester, MA 01605
Phone (347) 463-5529

186 N Main St
Fl 2
Plymouth, MI 48170
Phone (248) 602-3303

4444 The Plaza
Unit 18
Charlotte, NC 28215

4444 The Plaza
Charlotte, NC 28215
Phone (336) 360-2407

1439 E Cone Blvd
Greensboro, NC 27405
Phone (336) 375-6104

1259 Bedford Ave
Brooklyn, NY 11216
Phone (347) 463-5529

495 Flatbush Ave
Brooklyn, NY 11225
Phone 80033611001

495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (215) 588-1676

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

55 Water St
#4C
Brooklyn, NY 11201
Phone (917) 718-2063

546 Eastern Pkwy
Brooklyn, NY 11225
Phone (718) 604-4800

55 Washington St
Ste 552
Brooklyn, NY 11201

800 N High St
Ste 4102
Columbus, OH 43215
Phone (347) 463-5529

Networks

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

Interoperability endpoints

  • Direct secure messaging: oluwatoyin.ajayi@145331296403460.direct.elationemr.com
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
  • Direct secure messaging: oluwatoyin.ajayi.1@27775.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1790912426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 FLATBUSH AVE # C5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112251604",
            "telephone_number": "833-904-2273",
            "fax_number": "617-414-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "OLUWATOYIN",
        "middle_name": "T",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-21",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "62179",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "250701",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-01142",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "292657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093419A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.