Temitope A Olumoko, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C03017 Issued in MD

Practice address

1940 W Baltimore St
3Rd Floor
Baltimore, MD 21223-2245

Phone

(410) 362-3612

NPI assigned

Jul 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Temitope A Omoniyi Former name

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Grace Medical Center, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1801135439
  Medicare reassignment NPD
• Grace Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1104151091
  NPD

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1154511889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W BALTIMORE ST",
            "address_2": "3RD FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232245",
            "telephone_number": "410-362-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W BALTIMORE ST",
            "address_2": "3RD FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232245",
            "telephone_number": "410-362-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUMOKO",
        "first_name": "TEMITOPE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C03017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEMITOPE",
            "last_name": "OMONIYI",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Elisabeth Olson, MD
• Sarita Weiss Olson, LCSW-C
• Jason Olszewski
• Oyetola Olufidipe, PHARMD
• Jean Chinwe Olumba, MD
• Catherine Funmi Oluniyi
• Yanique Kayana Oluwafemi, DPT
• Fayoke Oluwasola
• Oluwabunmi Oluwayinka
• Banke Oluwole, RN, PMHNP

• Medical Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.