Olumide Samson Fagbemi, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.022296 Issued in IL

Practice address

1118 Lucas St
Calumet City, IL 60409-2408

Phone

(708) 785-2238

NPI assigned

Aug 13, 2008

Last updated

Nov 18, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Post Acute Care PLLCGroup PAC ID 0143547117, 125 clinicians

HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians

Value Based Long Term Care H PCGroup PAC ID 4587104641, 145 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Post Acute Care PLLC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1083012074

  IN

  Medicare reassignment Care Compare group NPD
• HDC Care Solutions, LLC

  • Nurse Practitioner
  • Framingham, MA
  • NPI 1033861349

  Family, IL

  Medicare reassignment Care Compare group NPD
• Value Based Long Term Care H PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Framingham, MA
  • NPI 1134951676

  IL

  Medicare reassignment Care Compare group NPD
• Altea Medical Illinois PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago Heights, IL
  • NPI 1447039227
  Medicare reassignment NPD
• Midwest Post Acute Care Aco PLLC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1457926537

  IN

  Medicare reassignment NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment NPD
• Healthdrive Medical Services Southeast LLC

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1437930146

  Family, IL

  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  IL

  Medicare reassignment NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  IL

  Medicare reassignment NPD
• Altea Medical Alaska LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1013727437
  NPD (past)

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1013163765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 LUCAS ST",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092408",
            "telephone_number": "708-785-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 LUCAS ST",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092408",
            "telephone_number": "708-785-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBEMI",
        "first_name": "OLUMIDE",
        "middle_name": "SAMSON",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "URL",
            "affiliation": "N",
            "endpointDescription": "HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "1118 Lucas St",
            "city": "Calumet City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604092408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ej Health Solutions Inc
• Onuwa Juliet Ejechi I
• Riham Elzaeim
• Martha Elaine Erbes
• Eyetopia, Inc
• Family Dental Care of Calumet City
• Family First Transportation Corp
• Idowu Florence Fapohunda
• Mittie Farland
• Yvette Marie Farmer, LCPC

• Family Nurse Practitioner in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.