Individual provider Active NPI

Oluwatosin Segun Fawibe, MD

  • Surgery Physician
  • Bakersfield, CA
National Provider Identifier
1043715733
Registry record updated Aug 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A174644 Issued in CA
Practice address
3838 San Dimas St Ste B231
Bakersfield, CA 93301-1494
Phone
(661) 665-0505
Fax
(661) 665-7844
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A174644 CA Primary

Addresses

Primary practice location

3838 San Dimas St Ste B231
Bakersfield, CA 93301-1494

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230728002259 CA Practitioner - General Surgery 9234590811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

3838 San Dimas St
Suite B231
Bakersfield, CA 93301-1494
Phone (661) 665-0505

Hospital & facility affiliations

  • Mercy Hospital Hospital, Bakersfield, CA, CCN 050295
  • Bakersfield Memorial Hospital Hospital, Bakersfield, CA, CCN 050036

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A174644CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 21, 2023 Accepting new patients
Dignity Health Medical Foundation CurrentSince Aug 21, 2023 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients

Locations

3838 San Dimas St
Ste B201
Bakersfield, CA 93301
Phone (661) 321-3161

3838 San Dimas St
Ste B231
Bakersfield, CA 93301
Phone (661) 665-0505

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

707 W Valley Blvd
Tehachapi, CA 93561
Phone (661) 822-2530

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 2

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1043715733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SAN DIMAS ST STE B231",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933011494",
            "telephone_number": "661-665-0505",
            "fax_number": "661-665-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWIBE",
        "first_name": "OLUWATOSIN",
        "middle_name": "SEGUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A174644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.