Olusoji Derek Olakanpo, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101255475 Issued in VA

Practice address

3344 Chambers Rd Ste 100
Horseheads, NY 14845-1403

Phone

(607) 734-2264

NPI assigned

May 28, 2013

Last updated

May 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, NY2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Mass General Brigham Medical Group Western Massachusetts Inc

  • Family Medicine Physician
  • Northampton, MA
  • NPI 1295787919

  Pediatrics

  Medicare reassignment NPD
• Twilight Pediatric Medicine

  • Pediatrics Physician
  • Freeville, NY
  • NPI 1851231575
  NPD Authorized official
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1013354372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUTHRIE SOUTHERN TIER PEDIATRICS",
            "address_2": "3344 CHAMBERS RD #200",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148452925",
            "telephone_number": "607-734-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 CHAMBERS RD STE 100",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148451403",
            "telephone_number": "607-734-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAKANPO",
        "first_name": "OLUSOJI",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-28",
        "last_updated": "2021-05-14",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD042002",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "16557",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0076470",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "052193",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101255475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nurtured Beginnings LCSW Therapy, PLLC
• Ameigh O'Connell
• Michael John O'Connor, O.D.
• Cindy Obazuaye
• Philip Jay Odessky
• Samuel Olczyk, PHARMD
• Orchard Family Health Care
• Julianne None Osborn, LPN
• Wendy Yvonne Ott, M.S. CCC-SLP
• Pamela Jean Overdurf, LMSW

• Pediatrics Physician in Horseheads, NY
• Providers in Horseheads, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.