Individual provider Active NPI

Oluwaseyi Oyelaja

  • Internal Medicine Physician
  • Fresh Meadows, NY
National Provider Identifier
1811650039
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P111398 Issued in NY
Practice address
6136 170TH St
Fresh Meadows, NY 11365-1900
Phone
(323) 615-9528
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P111398 NY Primary

Addresses

Primary practice location

6136 170TH St
Fresh Meadows, NY 11365-1900

Mailing address

36 Hawthorne PL
Montclair, NJ 07042-3229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220509002049 NY Practitioner - Internal Medicine 4284011495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.73 of 100Reported as group
Quality
88.19
Improvement activities
40
Cost
64.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P111398NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC CurrentSince Oct 15, 2023 Accepting new patients
Ion Oltean Physician PC Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
My Medical PC Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Peyman Younesi MD PLLC Internal Medicine PastSince Oct 17, 2021 Accepting new patients

Locations

22 Robert R Kasin Way
Beacon, NY 12508
Phone (845) 231-5792

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1811650039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HAWTHORNE PL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 170TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651900",
            "telephone_number": "323-615-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYELAJA",
        "first_name": "OLUWASEYI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P111398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.