Individual provider Active NPI

Ayotunde B Fadayomi, MD

  • Pain Medicine (Anesthesiology) Physician
  • Cape Girardeau, MO
National Provider Identifier
1033671854
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
2024036733 Issued in MO
Practice address
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone
(573) 331-5329
Fax
(573) 331-5085
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35.148520 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 35.148520 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 2024036733 MO Primary

Addresses

Primary practice location

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MO2 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

Enrollment IDStateProvider typePAC IDDetails
I20240903002912 OH Practitioner - Anesthesiology 5395071617 Reassigns benefits to 1 organization
I20241001000517 MO Practitioner - AnesthesiologyPractitioner - Pain Management 5395071617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024036733MOMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bel-Park Anesthesia Associates, Inc. Anesthesiology CurrentSince Aug 12, 2024 Accepting new patients
Saint Francis Medical Center Anesthesiology Current Accepting new patients
Acuity Anesthesiology LLC Anesthesiology CurrentSince Aug 1, 2025 Accepting new patients
Saint Francis Medical Center CurrentSince Oct 21, 2024 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Oct 21, 2024 Accepting new patients

Locations

865406 Reliable Pkwy
Chicago, IL 60686

3250 Gordonville Rd
Ste 450
Cape Girardeau, MO 63703
Phone (573) 331-5329

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Interoperability endpoints

  • Direct secure messaging: afadayomi109599@surescripts.sfmc.net

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1033671854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-5329",
            "fax_number": "573-331-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAYOMI",
        "first_name": "AYOTUNDE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.148520",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35.148520",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2024036733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.