Active NPI
Olusegun O. Osinbowale, M.D.
- Internal Medicine Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301119316
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (919) 397-9772
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35-0836040 | OH | |
| Cardiovascular Disease Physician | 207RC0000X | MD.202262 | LA | |
| Cardiovascular Disease Physician | 207RC0000X | 2016-01051 | NC | |
| Cardiovascular Disease Physician | 207RC0000X | 4301119316 | MI | |
| Internal Medicine Physician | 207R00000X | 4301119316 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
Henry Ford Health System
2799 W. Grand Blvd.
Detroit, MI 48202
Phone (919) 397-9772
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1313815 | Medicaid | LA | |
| 05559318 | Medicaid | MS | |
| 1114065547 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Cincinnati College of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Henry Ford Semi Medical Group
Practice addresses (Care Compare)
17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
- Henry Ford Home Health Care
- Henry Ford Health Hospital
- Wyandotte Hospital and Medical Center
- Henry Ford Health West Bloomfield Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-0836040 | OH | MD | Internal Medicine Physician |
| 2016-01051 | NC | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Wyandotte Hospital | Cardiovascular Disease | Current | Accepting new patients |
| Henry Ford Wyandotte Hospital | Current | Accepting new patients | |
| Henry Ford Health System | Cardiovascular Disease | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Rex Hospital Inc | Cardiovascular Disease | Past | Accepting new patients |
| Henry Ford Maplegrove Center | Past | Accepting new patients |
Locations
1961 S Telegraph Rd
Bloomfield Township, MI 48302
Phone (248) 319-6190
23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
2799 W Grand Blvd
#5
Detroit, MI 48202
Phone (313) 916-2710
6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000
2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000
2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482
Interoperability endpoints
- oosinbowale573465@direct.hfhs.org
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Cardiovascular Disease Physician
- Wyandotte, MI
- NPI 1700145851
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Cardiovascular Disease Physician
- Detroit, MI
- NPI 1982787487
-
- Community/Retail Pharmacy
- Brownstown TWP, MI
- NPI 1356356984
-
- Children's Substance Abuse Rehabilitation Facility
- West Bloomfield, MI
- NPI 1295767630
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1972939643
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- General Acute Care Hospital
- West Bloomfield, MI
- NPI 1407867559
-
- Home Health Agency
- Detroit, MI
- NPI 1932162096
-
- Ambulatory Surgical Clinic/Center
- Wyandotte, MI
- NPI 1093901035
Hospital
-
- General Acute Care Hospital
- Wyandotte, MI
- NPI 1992725352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677628800000",
"number": "1114065547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "2799 W. GRAND BLVD.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "919-397-9772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "919-397-9772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSINBOWALE",
"first_name": "OLUSEGUN",
"middle_name": "O.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2023-03-01",
"certification_date": "2023-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35-0836040",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "LA",
"license": "MD.202262",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NC",
"license": "2016-01051",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MI",
"license": "4301119316",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301119316",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1313815",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05559318",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1114065547",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.