Olukayode Olufayo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24459 Issued in MD

Practice address

5193 Mudville LN
Waldorf, MD 20602-4217

Phone

(301) 605-5955

NPI assigned

Feb 12, 2013

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Graceful Hands Telecare LLC

  • Physical Medicine & Rehabilitation Physician
  • Waldorf, MD
  • NPI 1821633504

  MD, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1902145808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5193 MUDVILLE LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206024217",
            "telephone_number": "301-605-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5193 MUDVILLE LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206024217",
            "telephone_number": "301-605-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUFAYO",
        "first_name": "OLUKAYODE",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-12",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "24459",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.gracefulhandstelecare.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5193 Mudville Ln",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206024217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eunice A Olaitan
• Stella Olamuyiwa
• Old Line Medical Services, P.C.
• Shontese Oliver
• Bradley J Olson, DDS
• Olukemi Ajayi Olugemo, M.D.
• Aina Oluwo, PMHNP -BC
• Olubunmi Oluyede
• Omar F. Ahmad, M.D., P.C.
• Omg Holding LLC Dba Arcpoint Labs Southern Maryland

• Physical Therapist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.