Dr Olutayo Olaide Olasupo, MD in Far Rockaway, NY

Dr Olutayo Olaide Olasupo, MD is a medicare enrolled "Internal Medicine" physician in Far Rockaway, New York. His current practice location is 529 Beach 20th St, Far Rockaway, New York. You can reach out to his office (for appointments etc.) via phone at (718) 327-7307.

Dr Olutayo Olaide Olasupo is licensed to practice in New York (license number P128167) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114713054.

Contact Information

	Dr Olutayo Olaide Olasupo, MD
	529 Beach 20th St, Far Rockaway, NY 11691-3615
	(718) 327-7307
	(718) 327-3294

Map and Direction

Physician's Profile

Full Name	Dr Olutayo Olaide Olasupo
Gender	Male
Speciality	Internal Medicine
Location	529 Beach 20th St, Far Rockaway, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114713054
Provider Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025

Medicare PECOS Information:

PECOS PAC ID: 9133644057
Enrollment ID: I20250423000931

Medical Identifiers

Medical identifiers for Dr Olutayo Olaide Olasupo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114713054	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	P128167 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Olutayo Olaide Olasupo allows following entities to bill medicare on his behalf.

Entity Name	Multiviz Medical Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720373293 PECOS PAC ID: 1557274735 Enrollment ID: O20031112000674

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Olutayo Olaide Olasupo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Olutayo Olaide Olasupo, MD 529 Beach 20th St, Far Rockaway, NY 11691-3615 Ph: (718) 327-7307	Dr Olutayo Olaide Olasupo, MD 529 Beach 20th St, Far Rockaway, NY 11691-3615 Ph: (718) 327-7307

Reviews and Comments

Internal Medicine Doctors in Far Rockaway, NY

Daniel Buff, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 327 Beach 19th Street, Far Rockaway, NY 11691 Phone: 718-869-7672
Dr. Albert Baravarian, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 529 Beach 20th St, Far Rockaway, NY 11691 Phone: 718-327-7307 Fax: 718-327-3294
Mohammad Rao, Internal Medicine Medicare: Medicare Enrolled Practice Location: 327 Beach 19th St, Far Rockaway, NY 11691 Phone: 718-869-7672
Israel Brafman, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1159 Beach 9th Street, Far Rockaway, NY 11691 Phone: 718-471-2455
Christopher Emovon, Internal Medicine Medicare: Medicare Enrolled Practice Location: 529 Beach 20th St, Far Rockaway, NY 11691 Phone: 718-327-7307
Dr. Marie Aurore Felix, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1311 Virginia St, Far Rockaway, NY 11691 Phone: 718-327-2909

Dr Olutayo Olaide Olasupo, MD - Medicare Internal Medicine in Far Rockaway, NY