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DR. ADEOLU OLAWUMI ILESANMI MD
NPI 1962957134
Psychiatry & Neurology - Child & Adolescent Psychiatry in New York, NY

Active since August 17, 2016PECOS Enrolled
622 W 168TH ST, NEW YORK, NY 10032(347) 559-1735(336) 900-1412 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 13, 2025, Aug 17, 2016 (2 updates tracked since 2016).

About Dr. Adeolu Olawumi Ilesanmi Md NPPES

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

DR. ADEOLU OLAWUMI ILESANMI MD (NPI 1962957134) is an individual child & adolescent psychiatry provider in New York, New York, licensed in New York (311181) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1962957134
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. ADEOLU OLAWUMI ILESANMICredential: MD
Location Address622 W 168TH STNew York, NY 10032-3720
Mailing Address622 W 168th StNew York, NY 10032-3720
Phone(347) 559-1735
Fax(336) 900-1412
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateAugust 17, 2016
Last NPPES UpdateAugust 13, 20252 updates tracked since enumeration
NPPES CertifiedAugust 13, 2025
✔ NPI 1962957134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in NY · 311181
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
622 W 168TH ST, New York, NY 10032
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Adeolu Olawumi Ilesanmi Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294225678
PECOS Enrollment IDI20251104004617
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.

Medicare Billing Reassignment

Medicare enrollment records show Adeolu Ilesanmi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Trustees Of Columbia University In The City Of New York
Same address
Surgery
622 W 168TH ST
New York, NY 10032
  • Reassigned Medicare billing, New York enrollment
  • 3,922 clinicians in this Medicare group
NPI 1508266347 (646) 317-7111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. PIETRO ALESSANDRO AMBROGIO CANETTA M.D.
Internal Medicine (Nephrology)
622 W 168TH ST, PH4-124
NEW YORK, NY 10032
New York County (212) 305-5020
CHARLES D RESOR
Internal Medicine
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-2913
MR. CALVIN KAILUN LEE NP
Nurse Practitioner (Adult Health)
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-0914
DI FAN CONEYBEARE M.D.
Emergency Medicine
622 W 168TH ST
NEW YORK, NY 10032
New York County (760) 808-2557
JONATHAN LE PHARM.D.
Pharmacist
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 342-8645
ASHLEE A CAMPBELL
Student in an Organized Health Care Education/Training Program
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6100
DR. EMILY SPIERA MD, MPH
Student in an Organized Health Care Education/Training Program
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6262
SAAGAR MADHAV PANDE
Student in an Organized Health Care Education/Training Program
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6100

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 Adeolu Ilesanmi's NPI number?

The NPI number for Adeolu Ilesanmi is 1962957134. It was assigned to this individual provider in the NPPES registry on August 17, 2016.

Where is Adeolu Ilesanmi located?

Adeolu Ilesanmi practices at 622 W 168th St, New York, NY 10032. The listed phone number is (347) 559-1735.

What is Adeolu Ilesanmi's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Adeolu Ilesanmi enrolled in Medicare?

Yes. Adeolu Ilesanmi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Adeolu Ilesanmi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adeolu Ilesanmi reassigns Medicare benefits to Trustees Of Columbia University In The City Of New York (New York, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Adeolu Ilesanmi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Adeolu Ilesanmi was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.