Individual provider Active NPI

Olufunso A Ojo, M.D

  • Internal Medicine Physician
  • Lithonia, GA
National Provider Identifier
1316991748
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
054004 Issued in GA
Practice address
8225 Mall Pkwy
Suite 240
Lithonia, GA 30038-6946
Phone
(770) 484-3092
Fax
(770) 484-3096
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 054004 GA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 054004 GA

Addresses

Primary practice location

8225 Mall Pkwy
Suite 240
Lithonia, GA 30038-6946

Mailing address

PO Box 451228
Atlanta, GA 31145-9228
Phone (770) 484-3092

Other identifiers 1

IdentifierTypeStateIssuer
619739917BMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040910000150 GA Practitioner - Internal Medicine 1850368846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8225 Mall Pkwy
Suite 240
Lithonia, GA 30038-6995
Phone (770) 341-8629

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054004GAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Internal Medicine Associated PC Internal Medicine CurrentSince Jan 1, 2006 Accepting new patients

Locations

8225 Mall Pkwy
Ste 240
Lithonia, GA 30038
Phone (770) 341-8629

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEHJBD/Endpoint/EEHJBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1316991748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451228",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311459228",
            "telephone_number": "770-484-3092",
            "fax_number": "770-484-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 MALL PKWY",
            "address_2": "SUITE 240",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386946",
            "telephone_number": "770-484-3092",
            "fax_number": "770-484-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJO",
        "first_name": "OLUFUNSO",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "054004",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "054004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "619739917B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

Verify at the official NPI Registry.