Omofolarin Babatunji Fasuyi, M.D, M.P.H

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2016023338 Issued in MO

Practice address

1605 Martin Springs Dr
Suite 210
Rolla, MO 65401-2982

Phone

(573) 458-6326

NPI assigned

Apr 22, 2013

Last updated

Jul 21, 2022By 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 1

Addresses

Other identifiers 1

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

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ofasuyi2739704@carolinashealthcaresystem.direct-ci.com
• Direct secure messaging: omofolarin.fasuyi.1@24920.direct.athenahealth.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.

• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324
  Medicare reassignment Care Compare group NPD
• Morehouse Medicine Inc.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1700673571

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104260090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "SUITE 210",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012982",
            "telephone_number": "573-458-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "SUITE 210",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012982",
            "telephone_number": "573-458-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASUYI",
        "first_name": "OMOFOLARIN",
        "middle_name": "BABATUNJI",
        "name_prefix": "Dr.",
        "credential": "M.D, M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2016023338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104260090",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy L. Fair-Parsons, PA-C
• David E Falkenhain, O.D.
• Linda Lee Falkenhain, LCSW
• Vernon Edward Falkenhain, O.D.
• Dmitry Familtsev, M.D., PH.D.
• Tasnim Fatima
• Randee Jo Feco
• Rachel Ann Feeler, CNP
• James A. Felts, MD
• FHL Dental LLC

• Family Medicine Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.