Omolola Oladunni Idowu, MD

Primary specialty

Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X

License

20872 Issued in MS

Practice address

2500 N State St
Suite B319
Jackson, MS 39216-4500

Phone

(601) 948-5022

NPI assigned

Sep 10, 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 identifiers 3

Medicare fee-for-service enrollment

Enrolled in MD, WI2 enrollments

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 2

Specialty

Ophthalmology

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspirus Rhinelander and Tomahawk Hospitals and Clinics, Inc.Group PAC ID 9335059856, 566 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment Care Compare group NPD
• Aspirus Merrill Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Merrill, WI
  • NPI 1124084678
  Medicare reassignment NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230
  Medicare reassignment NPD
• Aspirus Wausau Hospital, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1922321140
  Medicare reassignment NPD
• University of Maryland Eye Associates, P.a.

  • Ophthalmology Physician
  • Baltimore, MD
  • NPI 1285655829
  Medicare reassignment NPD
• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  NPD
• Altru Health System

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  NPD
• Aspirus Merrill Hospital & Clinics, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Merrill, WI
  • NPI 1407096266
  NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Iola, WI
  • NPI 1578232849
  NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1679706022
  NPD
• Aspirus Wausau Hospital, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1174601876
  NPD

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1194910448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5017",
            "fax_number": "601-984-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "SUITE B319",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-948-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU",
        "first_name": "OMOLOLA",
        "middle_name": "OLADUNNI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "MS",
            "license": "20872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09053511",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P0787985",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1338435",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• HZ Therapy
• I Care Optical, Inc.
• Justine Eve Maril Buslon Ibale
• Abdulgafar Dare Ibrahim, MD
• Hanan Ibrahim
• Chinedu Ifejiagwa, MD
• Riwad Iftekhar
• Dessislava Dimotrova Iliev, M.D.
• Peter Bratovanov Iliev, M.D.
• Benjamin Illich

• Glaucoma Specialist (Ophthalmology) Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Glaucoma Specialist (Ophthalmology) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.