Adesola Omotayo Fabayo, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

045782 Issued in GA

Practice address

610 S 8TH St
Suite F
Griffin, GA 30224-4201

Phone

(770) 228-8550

Fax

(770) 228-1478

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, NY2 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

Anesthesiology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverdale Anesthesia Services LLCGroup PAC ID 2163952284, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Regional Medical Center Hospital, Riverdale, GA, CCN 110165

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18187/brand/1/csg/1/fhir/r4

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.

• Riverdale Anesthesia Services LLC

  • Anesthesiology Physician
  • Riverdale, GA
  • NPI 1831910512
  Medicare reassignment Care Compare group NPD
• Coastal Ambulatory Anesthesia LLC

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1750753786
  Medicare reassignment NPD
• Gi Anesthesia of Georgia LLC

  • Certified Registered Nurse Anesthetist
  • Gainesville, GA
  • NPI 1326569187

  Anesthesiology

  Medicare reassignment NPD
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Medicare reassignment NPD
• Oswego Hospital

  • Anesthesiology Physician
  • Oswego, NY
  • NPI 1255639043
  NPD
• Apollomd Group Services, LLC

  • Anesthesiology Physician
  • Griffin, GA
  • NPI 1568616860
  NPD (past)
• Georgia Pain and Spine Solutions, PC

  • Pain Medicine (Anesthesiology) Physician
  • Hiram, GA
  • NPI 1255820502
  NPD (past)
• Newnan Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1033300298
  NPD (past)
• Spalding Anesthesia Associates PC

  • Pain Medicine (Anesthesiology) Physician
  • Griffin, GA
  • NPI 1821046764
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Foundation - Southern Regional, LLC

  dba Southern Regional Medical Center

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1154795581
  Care Compare affiliation

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1265482285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S 8TH ST",
            "address_2": "SUITE F",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244201",
            "telephone_number": "770-228-8550",
            "fax_number": "770-228-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S 8TH ST",
            "address_2": "SUITE F",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244201",
            "telephone_number": "770-228-8550",
            "fax_number": "770-228-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABAYO",
        "first_name": "ADESOLA",
        "middle_name": "OMOTAYO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "45782",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "045782",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "045782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000870669B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00870669A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.