Individual provider Active NPI

Olubunmi Titilope Pitan, MD

  • Hospitalist Physician
  • Gainesville, GA
National Provider Identifier
1104174523
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
074717 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
Fax
(770) 538-7872
NPI assigned
Aug 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 074717 GA
Interventional Pain Medicine Physician 208VP0014X 074717 GA
Hospitalist Physician 208M00000X 074717 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000

Other practice location 2

715 Queen City Pkwy Ste 106
Gainesville, GA 30501-4335
Phone (678) 450-1222

Other names 1

  • Olubunmi Titilope Anibaba Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oanibaba39009@nghs.gadirect.net Direct Northeast Georgia Physicians Group, Inc.

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151104001851 GA Practitioner - HospitalistPractitioner - Internal Medicine 2365752235 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 219-6000

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Mountain Lakes Medical Center Hospital, Clayton, GA, CCN 111336

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Aug 20, 2018 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Center for Spine & Pain Medicine, PC Current Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Feb 15, 2017 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Feb 15, 2017 Accepting new patients
Northeast Georgia Physicians Group Inc Internal Medicine CurrentSince Sep 5, 2017 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1413 Chattanooga Ave
Dalton, GA 30720
Phone (706) 279-2635

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

5440 Hillandale Dr
Lithonia, GA 30058
Phone (770) 322-2716

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

Interoperability endpoints

  • Direct secure messaging: opitan2022344@direct.trinity-health.org

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 5

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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1104174523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000",
            "fax_number": "770-538-7872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-219-9000",
            "fax_number": "770-538-7872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Queen City Pkwy Ste 106",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305014335",
            "country_code": "US",
            "telephone_number": "678-450-1222",
            "fax_number": "706-279-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITAN",
        "first_name": "OLUBUNMI",
        "middle_name": "TITILOPE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "074717",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "074717",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "074717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oanibaba39009@nghs.gadirect.net",
            "affiliation": "Y",
            "affiliationName": "Northeast Georgia Physicians Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "OLUBUNMI",
            "last_name": "ANIBABA",
            "middle_name": "TITILOPE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.