NPIMap

Individual provider Active NPI

Olawale Mayokun Osunsanya, M.D.

  • Nephrology Physician
  • Dothan, AL
National Provider Identifier
1013998491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0026705 Issued in AL
Practice address
1763 E Main St
Dothan, AL 36301-3045
Phone
(334) 793-3319
Fax
(334) 793-2291
NPI assigned
Nov 10, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0026705 AL Primary

Addresses

Primary practice location

1763 E Main St
Dothan, AL 36301-3045

Mailing address

1763 E Main St
Dothan, AL 36301-3045
Phone (334) 793-3319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000343 AL Practitioner - NephrologyPractitioner - Internal Medicine 1355372061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothan Hypertension Nephrology AssociatesGroup PAC ID 5991746661, 11 clinicians

Practice addresses (Care Compare)

207 Haven Dr
Dothan, AL 36301-2919
Phone (334) 793-3319

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.4 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0026705ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Hypertension Nephrology Associates CurrentSince Jul 11, 2005 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1763 E Main St
Dothan, AL 36301
Phone (334) 673-0246

207 Haven Dr
Dothan, AL 36301
Phone (334) 793-1964

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/donalso-e0e81471
  • Direct secure messaging: olawale.osunsanya@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013998491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013045",
            "telephone_number": "334-793-3319",
            "fax_number": "334-793-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1763 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013045",
            "telephone_number": "334-793-3319",
            "fax_number": "334-793-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSUNSANYA",
        "first_name": "OLAWALE",
        "middle_name": "MAYOKUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "0026705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.