Oladepo Collins Fasoranti, MBBS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

001220 Issued in GA

Practice address

11475 Robinson Drive NW - Mailstop 32600a
Healthpartners Coon Rapids Clinic
Coon Rapids, MN 55433-3746

Phone

(763) 587-9000

Fax

(763) 587-9130

NPI assigned

Apr 7, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ofasoranti44322@direct.healthpartners.com

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1003939968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "763-587-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11475 ROBINSON DRIVE NW - MAILSTOP 32600A",
            "address_2": "HEALTHPARTNERS COON RAPIDS CLINIC",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333746",
            "telephone_number": "763-587-9000",
            "fax_number": "763-587-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASORANTI",
        "first_name": "OLADEPO",
        "middle_name": "COLLINS",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "001220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENCY TRAINING PERMI",
            "identifier": "001220",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSP. PHYSICIAN  ID  #",
            "identifier": "20787",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Fanberg
• Autumn E. S. R. Fancher, LPCC
• Deka Farah
• Daniel McGeary Farber, MD
• Daniel John Farnham, CRNA
• Ashley Fatheree
• Jessica Chiyoko Fedor, O.D.
• Andrew Feld, PHARM.D.
• Carly Felicetta
• Kayla Margaret Felix, MHP, MS

• Family Medicine Physician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.