Individual provider Active NPI

Olulade Fasanmade, MD

  • Internal Medicine Physician
  • Lumberton, NC
National Provider Identifier
1194462499
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0105994 Issued in MD
Practice address
395 W 27TH St
Lumberton, NC 28358-3018
Phone
(910) 739-7551
NPI assigned
May 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0105994 MD Primary

Addresses

Primary practice location

395 W 27TH St
Lumberton, NC 28358-3018

Mailing address

395 W 27TH St
Lumberton, NC 28358-3018
Phone (910) 739-7551

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260327002521 MD Practitioner - Internal Medicine 6608351630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Associates P.a., P.C.Group PAC ID 8022914522, 706 clinicians

Practice addresses (Care Compare)

200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 871-6700

Hospital & facility affiliations

  • Carroll Hospital Center Hospital, Westminster, MD, CCN 210033
  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0105994MDMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ofasanmade324537@direct.unc.nchie.net

Organizations & group practices 1

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 3

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1194462499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583018",
            "telephone_number": "910-739-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583018",
            "telephone_number": "910-739-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANMADE",
        "first_name": "OLULADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0105994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.