Oluyinka Olowolafe Reno, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

230755 Issued in MA

Practice address

65 Libby St
Brockton, MA 02302-2949

Phone

(508) 584-6060

Fax

(508) 584-4949

NPI assigned

Apr 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Yinka Adenike Olowolafe Other name

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oluyinka.reno.npi1922061878.reliant@direct.optumcare.masshiway.net
• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528

  Pediatrics

  Medicare reassignment NPD
• Brockton Pediatrics

  • Primary Care Clinic/Center
  • Brockton, MA
  • NPI 1629001904
  NPD (past)
• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1922061878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-368-7887",
            "fax_number": "508-792-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 LIBBY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022949",
            "telephone_number": "508-584-6060",
            "fax_number": "508-584-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 N Bedford St",
            "address_purpose": "LOCATION",
            "city": "East Bridgewater",
            "state": "MA",
            "postal_code": "023331186",
            "country_code": "US",
            "telephone_number": "508-378-1280",
            "fax_number": "508-378-1284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENO",
        "first_name": "OLUYINKA",
        "middle_name": "OLOWOLAFE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "230755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110075448A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "230755",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YINKA",
            "last_name": "OLOWOLAFE",
            "middle_name": "ADENIKE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Renal Medical Care, PC
• Daina Rene
• Moise Rene
• Neila Berthe Rene
• Scheinda Rene, LCSW
• Lauren Reposa, CNP, FNP-C
• Maria Resende
• Molore J Resil, FNP
• Simona Retter, MD
• Pasquina Revanche

• Pediatrics Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.