Tinuola Omoniyi Andre, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

95863 Issued in GA

Practice address

1270 Prince Ave
Suite 201
Athens, GA 30606

Phone

(706) 475-7055

NPI assigned

Jun 2, 2020

Reactivated

Feb 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Tinuola Omoniyi Fakoya Other name

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

Internal Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Athens Hospitalist Physicians LLCGroup PAC ID 6305196411, 174 clinicians

Piedmont Athens Primary Care LLCGroup PAC ID 0648520841, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Home Health Home health agency, Athens, GA, CCN 117125
• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

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.

• Piedmont Athens Hospitalist Physicians LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1578079000
  Medicare reassignment Care Compare group NPD
• Piedmont Athens Primary Care LLC

  • Family Medicine Physician
  • Athens, GA
  • NPI 1245746783
  Medicare reassignment Care Compare group NPD
• Piedmont Hospitalist Physicians LLC

  • Family Medicine Physician
  • Stockbridge, GA
  • NPI 1548219660

  Internal Medicine

  Medicare reassignment NPD
• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  NPD (past)
• Piedmont Athens Specialty Care LLC

  • Cardiovascular Disease Physician
  • Athens, GA
  • NPI 1184130627
  NPD (past)

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

• Piedmont Athens Regional Medical Center, Inc.

  • Home Health Agency
  • Athens, GA
  • NPI 1053306191
  Care Compare affiliation
• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1083238448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVE",
            "address_2": "#70",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 PRINCE AVE",
            "address_2": "SUITE 201",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-475-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "TINUOLA",
        "middle_name": "OMONIYI",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "deactivation_date": "2022-01-18",
        "reactivation_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "95863",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "95863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINUOLA",
            "last_name": "FAKOYA",
            "middle_name": "OMONIYI",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marie B Anderson, P.A.
• Pamela Leigh Anderson, RPT
• Selah Anderson
• Sofia Anderson
• Victoria H Anderson, MD
• Katherine Johnson Andrews, RN
• Anesthesia Consultants of Athens
• Angels Mobile Phlebotomy Services LLC
• Lisa Beth Anger, LCSW
• Edem Sika Ankudey

• Internal Medicine Physician in Athens, GA
• Providers in Athens, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.