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JESUTOFUNMI ADESANMI OMIYE
NPI 1265285654
Student in an Organized Health Care Education/Training Program in Bridgeport, CT

Active since April 08, 2024PECOS Enrolled
267 GRANT ST, BRIDGEPORT, CT 06610(203) 384-3000 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Jesutofunmi Adesanmi Omiye NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESUTOFUNMI ADESANMI OMIYE (NPI 1265285654) is an individual student in an organized health care education/training program in Bridgeport, Connecticut and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265285654
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJESUTOFUNMI ADESANMI OMIYE
Location Address267 GRANT STBridgeport, CT 06610-2805
Mailing Address267 Grant StBridgeport, CT 06610-2870 · (203) 384-4442
Phone(203) 384-3000
Sole ProprietorNo
Enumeration DateApril 8, 2024
NPPES CertifiedApril 8, 2024
✔ NPI 1265285654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
267 GRANT ST, Bridgeport, CT 06610
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesutofunmi Adesanmi Omiye is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ALEX SCOTT CADAN PA-C
Physician Assistant (Surgical)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4500
RYAN KEENAN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
DR. BLAZE KELLY DO
Anesthesiology (Pain Medicine)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
KARINA K. LINCER
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
DOROTHY D. DAPONTE
Physical Therapy Assistant
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
MISS SANDRA SHIPKOWITZ APRN
Nurse Practitioner (Pediatrics)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4490
HOLLY S. ASHBY
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
TESSA GURALNICK DPT
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3708

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesutofunmi Omiye's NPI number?

The NPI number for Jesutofunmi Omiye is 1265285654. It was assigned to this individual provider in the NPPES registry on April 8, 2024.

Where is Jesutofunmi Omiye located?

Jesutofunmi Omiye practices at 267 Grant St, Bridgeport, CT 06610. The listed phone number is (203) 384-3000.

What is Jesutofunmi Omiye's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jesutofunmi Omiye enrolled in Medicare?

Yes. Jesutofunmi Omiye is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jesutofunmi Omiye was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.