Individual provider Active NPI

Oluseun O. Medeyinlo, M.D

  • Pulmonary Disease Physician
  • Florence, KY
National Provider Identifier
1205040136
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
41560 Issued in KY
Practice address
4900 Houston Rd
Florence, KY 41042-4824
Phone
(859) 212-7700
Fax
(859) 212-7710
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 41560 KY
Pulmonary Disease Physician 207RP1001X 238066 NY
Pulmonary Disease Physician 207RP1001X 41560 KY Primary

Addresses

Primary practice location

4900 Houston Rd
Florence, KY 41042-4824

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 212-7700

Other identifiers 4

IdentifierTypeStateIssuer
P00633297OtherKYRAILROAD MEDICARE
7100062500MedicaidKY
2966849MedicaidOH
P00840872OtherKYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20080730000039 KY Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary DiseasePractitioner - Other (Physician) 1052485786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-5901

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 301-5901

300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-4625

85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 301-5901

PO Box
Suite 635283
Cincinnati, OH 45263-5283

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41560KYMDPulmonary Disease Physician
238066NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jan 1, 2010 Accepting new patients
Summit Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
Neurological & Sleep Disorders Inc Pulmonary Disease Past Accepting new patients
Cincinnati Health Care Group PSC Past Accepting new patients
Select Specialty Hospital - Northern Kentucky LLC Past Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

2765 Chapel Pl
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-1900

340 Thomas More Pkwy
#160
Crestview Hills, KY 41017

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

525 Alexandria Pike
Ste 300
Southgate, KY 41071
Phone (606) 781-2210

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: omedeyinlo5737@direct-prd.stelizabeth.com

Organizations & group practices 5

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 4

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1205040136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-7700",
            "fax_number": "859-212-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 HOUSTON RD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424824",
            "telephone_number": "859-212-7700",
            "fax_number": "859-212-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEYINLO",
        "first_name": "OLUSEUN",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "KY",
            "license": "41560",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "238066",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "41560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00633297",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100062500",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2966849",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00840872",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.