Individual provider Active NPI

Aishat Olatunde, MD

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1891175980
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD473152 Issued in PA
Practice address
5501 Old York Rd Ste 3
Philadelphia, PA 19141-3018
Phone
(215) 456-7180
Fax
(215) 456-7052
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD60944164 WA
Obstetrics & Gynecology Physician 207V00000X MD473152 PA Primary

Addresses

Primary practice location

5501 Old York Rd Ste 3
Philadelphia, PA 19141-3018

Mailing address

101 E Olney Ave Ste 400
Philadelphia, PA 19120-2470
Phone (215) 456-1825

Other practice location 1

4245 Roosevelt Way NE
Seattle, WA 98105-6008
Phone (206) 598-5500

Other identifiers 1

IdentifierTypeStateIssuer
1891175980MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210830000469 PA Practitioner - Obstetrics/Gynecology 5395079883 Reassigns benefits to 1 organization
I20221230000263 NJ Practitioner - Obstetrics/Gynecology 5395079883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd
Phila, PA 19141-3018
Phone (215) 456-9850

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. Obstetrics & Gynecology CurrentSince Jun 15, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Aug 30, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Aug 30, 2021 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Dec 16, 2022 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Dec 16, 2022 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

205 E Laurel Rd
Stratford, NJ 08084
Phone (856) 344-7360

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5401 Old York Rd
Ste 4
Philadelphia, PA 19141
Phone (215) 456-6990

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

7201 Rising Sun Ave
Philadelphia, PA 19111
Phone (215) 722-8105

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1891175980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-456-1825",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD STE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7180",
            "fax_number": "215-456-7052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4245 Roosevelt Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056008",
            "country_code": "US",
            "telephone_number": "206-598-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLATUNDE",
        "first_name": "AISHAT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2021-09-16",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60944164",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD473152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891175980",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.