Adebusola Oyefeso, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

QA046620 Issued in NJ

Practice address

205 Main St
Matawan, NJ 07747-3127

Phone

(732) 583-8630

NPI assigned

Nov 6, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crown Rehab Inc.

  • Physical Therapist
  • Matawan, NJ
  • NPI 1063450963
  NPD (past) Authorized official

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1811393523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MAIN STREET",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "07747",
            "telephone_number": "732-583-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473127",
            "telephone_number": "732-583-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYEFESO",
        "first_name": "ADEBUSOLA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA046620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NJ BOARD OF PHYSICAL THERAPY",
            "identifier": "QA046620",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optometric Physicians of Middletown PA
• Stephanie Osinski
• Joseph Osty
• Ayesha Ouldhammou, MD
• Our Special Place, Inc.
• Adedolapo A Oyefeso Jr., PT, DPT
• P & Q Mental Health Clinic, LLC
• Pain Center NJ PC
• Cindy Panek, MSW LCSW
• Fazal R Panezai, M.D.

• Physical Therapist in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.