Individual provider Active NPI

Olayemi Motilola Ikusika, MD

  • Emergency Medicine Physician
  • Albany, NY
National Provider Identifier
1356522445
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
I222660609993 Issued in MD
Practice address
113 Holland Ave
Albany, NY 12208-3410
Phone
(518) 626-6600
NPI assigned
Nov 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X I222660609993 MD Primary

Addresses

Primary practice location

113 Holland Ave
Albany, NY 12208-3410

Mailing address

113 Holland Ave
Albany, NY 12208-3410
Phone (518) 626-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DC, OH4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20120126000134 PA Practitioner - Emergency MedicinePractitioner - General Surgery 3971770355 Reassigns benefits to 1 organization
I20120511000017 MD Practitioner - Emergency MedicinePractitioner - General Surgery 3971770355 Reassigns benefits to 4 organizations
I20150724011260 DC Practitioner - Emergency Medicine 3971770355 Reassigns benefits to 1 organization
I20200403002022 OH Practitioner - Emergency Medicine 3971770355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
  • Medstar Montgomery Medical Center Hospital, Olney, MD, CCN 210018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
I222660609993MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Physician Services, LLC Emergency Medicine Current Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 1, 2026 Accepting new patients
Mep Observation Services LLC Emergency Medicine CurrentSince Feb 11, 2026 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 1, 2026 Accepting new patients
Mep Observation Services LLC CurrentSince Feb 11, 2026 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
MNR Industries LLC Past Accepting new patients
Medexpress Urgent Care, PC - Monaca Emergency Medicine Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

2400 Lakeview Dr
#150
Beavercreek, OH 45431

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Organizations & group practices 11

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.

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": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1356522445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083410",
            "telephone_number": "518-626-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083410",
            "telephone_number": "518-626-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUSIKA",
        "first_name": "OLAYEMI",
        "middle_name": "MOTILOLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-17",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "I222660609993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.