Itauma Udosen, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

78910 Issued in GA

Practice address

2745 Dekalb Medical Pkwy Ste 110
Lithonia, GA 30058-4933

Phone

(770) 593-2382

Fax

(678) 514-2527

NPI assigned

Jun 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Philadelphia College of Osteopathic Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Atlanta, GA, CCN 117132
• Emory Hillandale Hospital Hospital, Lithonia, GA, CCN 110226
• Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
• Emory University Hospital Hospital, Atlanta, GA, CCN 110010

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iudosen20171@direct.emory.org

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.

• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

• Centerwell Certified Healthcare Corp.

  dba Centerwell Home Health

  • Home Health Agency
  • Atlanta, GA
  • NPI 1891725693
  Care Compare affiliation
• Crawford Long Hospital

  dba Emory University dba Emory Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation
• Dekalb Medical Center, Inc.

  dba Emory Decatur Hospital

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  Care Compare affiliation
• Dekalb Medical Center, Inc.

  dba Dekalb Medical Center at Hillandale

  • General Acute Care Hospital
  • Lithonia, GA
  • NPI 1962403865
  Care Compare affiliation
• Emory University

  dba Emory University Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1588640692
  Care Compare affiliation
• Emory University

  dba Emory University Hospital At Wesley Woods

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1770560294
  Care Compare affiliation

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265793616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 DEKALB MEDICAL PKWY STE 110",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584933",
            "telephone_number": "770-593-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 DEKALB MEDICAL PKWY STE 110",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584933",
            "telephone_number": "770-593-2382",
            "fax_number": "678-514-2527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Highway 138 SW",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302961404",
            "country_code": "US",
            "telephone_number": "770-907-4949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDOSEN",
        "first_name": "ITAUMA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2022-07-21",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "078910",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "78910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristar Injury Center of Lithonia LLC
• True You Wellness LLC
• Truecare Home Care Services, LLC
• Trulicare LLC
• Truresults Lab & Courier Services LLC
• Ultra Brite LLC
• Theresa Mishael Umoja, RN
• United Health Care Resource Service LLC
• Kenneth Unuovurhaye, RN
• Bryan Upshaw

• Sports Medicine (Family Medicine) Physician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Sports Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.