Individual provider Active NPI

Opeyemi Olatoye Daramola, M.D.

  • Otolaryngology Physician
  • Monroe, NY
National Provider Identifier
1972777860
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
288365 Issued in NY
Practice address
855 State Route 17M
Monroe, NY 10950-1600
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Apr 22, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA09449100 NJ
Otolaryngology Physician 207Y00000X MD458062 PA
Otolaryngology Physician 207Y00000X 288365 NY Primary

Addresses

Primary practice location

855 State Route 17M
Monroe, NY 10950-1600

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address opeyemi.daramolamd.p1@direct.crystalrun.nextgenshare.com Direct

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
I20170804000818 NY Practitioner - Otolaryngology 3476777582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Minnesota Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

48 Route 6 Mahopac Ave
Yorktown Heights, NY 10598
Phone (914) 248-5556

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09449100NJMDOtolaryngology Physician
288365NYMDOtolaryngology Physician
MD458062PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jul 7, 2021 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jul 7, 2021 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

3680 Hill Blvd
Jefferson Valley, NY 10535
Phone (914) 245-7700

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

48 Route 6
Yorktown Heights, NY 10598
Phone (914) 248-5556

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: odaramola141878@direct.optum.com
  • Direct secure messaging: odaramola67515@northwell.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972777860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501600",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARAMOLA",
        "first_name": "OPEYEMI",
        "middle_name": "OLATOYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA09449100",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD458062",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "288365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "opeyemi.daramolamd.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 State Route 17M",
            "city": "Monroe",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109501600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.