Emmanuel Olusegun Odeyemi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

54067 Issued in WI

Practice address

3400 Ministry Pkwy
Weston, WI 54476-5220

Phone

(715) 393-3000

NPI assigned

Apr 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Internal Medicine

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
• Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041

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.

• Aspirus Wausau Hospital, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1922321140

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Medicare reassignment Care Compare group NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230
  Medicare reassignment NPD
• St Clare Memorial Hospital, Inc

  • Critical Access Hospital
  • Oconto Falls, WI
  • NPI 1851477913
  Medicare reassignment NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • General Practice Physician
  • Green Bay, WI
  • NPI 1285613638

  Internal Medicine

  Medicare reassignment NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1275799413
  Medicare reassignment NPD
• The Howard Young Medical Center, Inc.

  • General Acute Care Hospital
  • Woodruff, WI
  • NPI 1184673352
  Medicare reassignment NPD
• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • General Acute Care Hospital
  • Rhinelander, WI
  • NPI 1356391247
  NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1679706022
  NPD
• Aspirus Wausau Hospital, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wausau, WI
  • NPI 1225905102
  NPD

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

• Aspirus Wausau Hospital Inc

  • Clinic/Center
  • Edgar, WI
  • NPI 1447580725

  Hospital

  Care Compare affiliation
• Aspirus Wausau Hospital Inc

  • Dermatology Physician
  • Wausau, WI
  • NPI 1477883759

  Hospital

  Care Compare affiliation
• Aspirus Wausau Hospital, Inc

  • Radiology Clinic/Center
  • Wausau, WI
  • NPI 1780014407

  Hospital

  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • Rehabilitation Clinic/Center
  • Wausau, WI
  • NPI 1083955165

  Hospital

  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • Family Medicine Physician
  • Stevens Point, WI
  • NPI 1275886749

  Hospital

  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1356576490

  Hospital

  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • General Acute Care Hospital
  • Wausau, WI
  • NPI 1558363986
  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1598375271
  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • General Acute Care Hospital
  • Wausau, WI
  • NPI 1902923170
  Care Compare affiliation
• Aspirus Wausau Hospital, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1952921405

  Hospital

  Care Compare affiliation
• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Care Compare affiliation

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1346566460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MINISTRY PKWY",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765220",
            "telephone_number": "715-393-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MINISTRY PKWY",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765220",
            "telephone_number": "715-393-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEYEMI",
        "first_name": "EMMANUEL",
        "middle_name": "OLUSEGUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "54067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LIC",
            "identifier": "54067",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Niemeyer, PTA
• Rachel Joy Niziolek, COMS, MA
• Tiffany Ciera Nooyen, R.N., BSN
• Vidallah Mulley Nordquist, DNP
• Northwoods Cab LLC
• Teri Ogiba, OTR
• Bolaji Olasusi
• Adedayo A Onitilo, MD
• Orthopaedic Centers of Wisconsin S C
• Choon H P'NG, M.D.

• Internal Medicine Physician in Weston, WI
• Providers in Weston, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.