NPIMap

Individual provider Active NPI

Grace Boluwape Olowo, MD

  • Internal Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1972980647
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
294393 Issued in NY
Practice address
HSC L2-144
Stony Brook, NY 11794
Phone
(631) 444-4630
Fax
(631) 444-4652
NPI assigned
May 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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 294393 NY Primary

Addresses

Primary practice location

HSC L2-144
Stony Brook, NY 11794

Mailing address

HSC L2-155
Stony Brook, NY 11794-8228
Phone (631) 444-4630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190110001662 NY Practitioner - Internal MedicinePractitioner - Hospitalist 1456697556 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
State University of New York Downstate Medical Center, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians
Maimonides Medical Center Maimonides Primary Care FPPGroup PAC ID 5991696916, 32 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-2689

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-7732

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259
  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194
  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Suffolk Medical PC CurrentSince Oct 28, 2025 Accepting new patients
Maimonides Medical Center Maimonides Primary Care FPP Internal Medicine CurrentSince May 13, 2024 Accepting new patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Maimonides Faculty Practice Plan Internal Medicine CurrentSince May 13, 2024 Accepting new patients
Southwest Suffolk Medical, P.C. Current Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Southwest Suffolk, P.C CurrentSince Oct 28, 2025 Accepting new patients
Maimonides Medical Center Past Accepting new patients
Mercy Medical Center Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 9

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 5

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1972980647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSC L2-155",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948228",
            "telephone_number": "631-444-4630",
            "fax_number": "631-444-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC L2-144",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-4630",
            "fax_number": "631-444-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOWO",
        "first_name": "GRACE",
        "middle_name": "BOLUWAPE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "294393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.