Active NPI
Emmanuel Olusegun Odeyemi, MD
- Internal Medicine Physician
- Weston, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 54067
- Practice address
- 3400 Ministry Pkwy
Weston, WI 54476-5220 - Phone
- (715) 393-3000
- NPI assigned
- Apr 14, 2010
- Last updated
- Apr 14, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 54067 | WI | Primary |
Addresses
Primary practice location
3400 Ministry Pkwy
Weston, WI 54476-5220
Mailing address
3400 Ministry Pkwy
Weston, WI 54476-5220
Phone (715) 393-3000
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131
333 Pine Ridge Blvd
Wausau, WI 54401-4102
Phone (715) 847-2866
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54067 | WI | MD | Internal Medicine Physician |
Practice roles
Locations
29980 Network Pl
Chicago, IL 60673
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509
855 S Main St
Oconto Falls, WI 54154
Phone (920) 846-3444
855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598
2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300
2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
209 Prentice St N
Stevens Point, WI 54481
Phone (715) 344-4611
900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500
401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700
190 Grand Seasons Dr
Waupaca, WI 54981
Phone (715) 258-3401
333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160
240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000
Organizations & group practices 18
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.
-
dba Aspirus Wausau Hospital Hospitalists
- Clinic/Center
- Wausau, WI
- NPI 1922321140
Internal Medicine
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
-
dba Aspirus Stevens Point Clinic - Illinois Avenue
- Clinic/Center
- Stevens Point, WI
- NPI 1144991340
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1538112230
-
- Critical Access Hospital
- Oconto Falls, WI
- NPI 1851477913
-
dba Prevea Health
- General Practice Physician
- Green Bay, WI
- NPI 1285613638
Internal Medicine
-
dba Prevea Sheboygan Health Center
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1275799413
-
dba Howard Young Medical Center
- General Acute Care Hospital
- Woodruff, WI
- NPI 1184673352
-
dba ThedaCare Physicians
- Family Medicine Physician
- New London, WI
- NPI 1376656959
-
- General Acute Care Hospital
- Rhinelander, WI
- NPI 1356391247
-
dba Aspirus Behavioral Health Clinic - Stevens Point - Prentice St
- Clinic/Center
- Stevens Point, WI
- NPI 1679706022
-
dba Aspirus Palliative Medicine- Wisconsin
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Wausau, WI
- NPI 1225905102
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Aspirus Edgar Clinic
- Clinic/Center
- Edgar, WI
- NPI 1447580725
Hospital
-
dba Aspirus Dermatology Clinic
- Dermatology Physician
- Wausau, WI
- NPI 1477883759
Hospital
-
dba Aspirus Imaging - Westwood
- Radiology Clinic/Center
- Wausau, WI
- NPI 1780014407
Hospital
-
dba Aspirus Outpatient Therapies - Pediatrics
- Rehabilitation Clinic/Center
- Wausau, WI
- NPI 1083955165
Hospital
-
dba Aspirus Plover Clinic
- Family Medicine Physician
- Stevens Point, WI
- NPI 1275886749
Hospital
-
dba Aspirus Regional Cancer Center
- Clinic/Center
- Wausau, WI
- NPI 1356576490
Hospital
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1558363986
-
dba Aspirus Plover Hospital
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1598375271
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1902923170
-
dba Aspirus Infectious Disease
- Clinic/Center
- Wausau, WI
- NPI 1952921405
Hospital
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Weston, WI
Sources for this page
- 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.