Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kolawole Bamgbelu

Individual provider Physical Therapist · NPI 1598426470

Kolawole Bamgbelu is a Physical Therapist in Private Practice in Great Neck, New York. Qualified in 2021, 5 years ago. Practices with Sports Physical Therapy Occupational Therapy and Rehabilitation Servic, a 529-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone: (516) 829-0030
Fax: (516) 466-7723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 048199 (NY)

Record details

NPI number1598426470
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 4, 2022
Last updated in NPPESJanuary 4, 2022
Certification dateJanuary 4, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Sports Physical Therapy Occupational Therapy And Rehabilitation Servic — 529 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Great Neck