Olufisayo Tayo Otusanya, M.B.CH.B

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

84957 Issued in GA

Practice address

135 N Park PL Ste 200
Stockbridge, GA 30281-7209

Phone

(678) 289-7960

NPI assigned

Jun 3, 2014

Sex

Male

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

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

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.

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment Care Compare group NPD
• Piedmont Specialty Hospital Billing LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1699290510
  Medicare reassignment Care Compare group NPD
• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment NPD
• Sound Physicians Intensivists of Georgia PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Macon, GA
  • NPI 1376159590

  Pulmonary Disease

  Medicare reassignment NPD
• Piedmont Cardiology of Atlanta, LLC

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1275729691
  NPD (past)
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  NPD (past)

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

• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation
• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1336552785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N PARK PL STE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N PARK PL STE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817209",
            "telephone_number": "678-289-7960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pelham Pkwy S",
            "address_2": "Jacobi Medical Center",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611138",
            "country_code": "US",
            "telephone_number": "718-918-5640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTUSANYA",
        "first_name": "OLUFISAYO",
        "middle_name": "TAYO",
        "name_prefix": "Dr.",
        "credential": "M.B.CH.B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "305582",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "84957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichelle Nicole Osborne, PMHNP
• James Oskam
• Osteostim LLC
• Matthew Edward Oster, MD
• Otto Bock Patient Care, LLC
• Ayana Ousley
• Out Tha Box Foundation
• Outreach Redemption, Corp
• Leo Ovadje, M.D.
• Antonette Michell Owens-Peete

• Pulmonary Disease Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.