Olatomide T Familusi, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

93753 Issued in GA

Practice address

6105 Peachtree Dunwoody Rd Ste C250
Atlanta, GA 30328-5942

Phone

(404) 857-4242

Fax

(404) 857-4617

NPI assigned

Apr 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Plastic and Reconstructive Surgery

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464

  Single Specialty

  Medicare reassignment NPD

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

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1053766352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 PEACHTREE DUNWOODY RD STE C250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285942",
            "telephone_number": "404-857-4242",
            "fax_number": "404-857-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 PEACHTREE DUNWOODY RD STE C250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285942",
            "telephone_number": "404-857-4242",
            "fax_number": "404-857-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMILUSI",
        "first_name": "OLATOMIDE",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "93753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Faluade
• Oluwabukola Naomi Famakinwa, DO
• Phillip Famber
• McCayn McDaniel Familia
• Families First
• Family 1St Medical Transportation
• Family Allergy & Asthma Center
• Family and Children'S Dentistry & Orthodontics
• Family and Children'S Dentistry, PC
• Family Care 360

• Plastic Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2024; 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.