Bamidele Ganiyu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2020002143 Issued in MO

Practice address

2101 Corona Rd Ste 102
Columbia, MO 65203-2582

Phone

(573) 234-1800

Fax

(573) 234-1799

NPI assigned

Oct 11, 2019

Last updated

Nov 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Little Hills Healthcare LLCGroup PAC ID 7719897529, 17 clinicians

Med Management of Kansas LLCGroup PAC ID 8325459159, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: banidele.ganiyu@bhm.gehrimeddirect.com

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.

• Mercy Aco Clinical Services Inc

  • Neurology Physician
  • Chesterfield, MO
  • NPI 1063965093
  Medicare reassignment Care Compare group NPD
• Med Management of Kansas LLC

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1942800859

  KS, MO

  Medicare reassignment Care Compare group NPD
• Little Hills Healthcare, LLC

  dba Centerpointe Hospital

  • Psychiatric Hospital
  • Saint Charles, MO
  • NPI 1659364206
  Medicare reassignment Care Compare group
• CH Specialty Services Mo LLC

  • Internal Medicine Physician
  • Lee's Summit, MO
  • NPI 1194422253
  Medicare reassignment NPD
• Curana Health of Missouri-Kansas LLC

  dba Elite Patient Care

  • Family Medicine Physician
  • Lee's Summit, MO
  • NPI 1306165337
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists - St. Louis, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1841235108
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists - Washington, LLC

  • Hospitalist Physician
  • Washington, MO
  • NPI 1891943429
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists- Jefferson, LLC

  • Internal Medicine Physician
  • Festus, MO
  • NPI 1083052492
  Medicare reassignment NPD
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment NPD
• Mercy East Support Services, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1225382013
  Medicare reassignment NPD
• St Anthonys Physician Organization Hospitalist Services, L.C.

  dba Mercy Clinic South Hospitalists

  • Hospitalist Physician
  • Saint Louis, MO
  • NPI 1407216336
  Medicare reassignment NPD
• Mindcare Solutions PC

  • Psychiatry Physician
  • Kansas City, MO
  • NPI 1437956935
  NPD

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1073155933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 DEREK DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633856841",
            "telephone_number": "314-960-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 CORONA RD STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032582",
            "telephone_number": "573-234-1800",
            "fax_number": "573-234-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANIYU",
        "first_name": "BAMIDELE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020002143",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "83508",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2020002143",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://baggotstreet.mercy.net/mylinks/common/mercywide",
            "affiliation": "N",
            "address_1": "615 S New Ballas Rd",
            "city": "Creve Coeur",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Banidele.Ganiyu@BHM.gehrimeddirect.com",
            "affiliation": "N",
            "address_1": "2101 Corona Rd Ste 102",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652032582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James E Gamble, O.D.
• Jeffrey M Gamble, OD
• Murtaza Hakim Gandhi, MD
• Mustafa Hakim Gandhi, MD
• Karthik Gangu, M.D.
• Sheila Ganley, OTR/L, C/NDT
• Lauren Gann, MD
• Mariah Stacy Gann, PA-C
• James R. L. Garb, MD
• Edward Anthony Garcia-Olmeda, MD

• Psychiatric/Mental Health Nurse Practitioner in Columbia, MO
• Providers in Columbia, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.