Individual provider Active NPI

Oluseyi O Fashusi, PA-C

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1407318553
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13225 Issued in MN
Practice address
8325 City Centre Dr
Woodbury, MN 55125-3323
Phone
(651) 731-0859
Fax
(651) 731-0976
NPI assigned
Apr 5, 2019
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13225 MN Primary

Addresses

Primary practice location

8325 City Centre Dr
Woodbury, MN 55125-3323

Mailing address

1026 7TH St W
Saint Paul, MN 55102-3828
Phone (651) 758-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191231001265 MN Practitioner - Physician Assistant 7113351099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1026 7TH St W
Saint Paul, MN 55102-3828
Phone (651) 758-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13225MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Family Practice Health Center CurrentSince Aug 15, 2025 Accepting new patients
United Family Practice Health Center CurrentSince Aug 15, 2025 Accepting new patients

Locations

1026 7th St W
Saint Paul, MN 55102
Phone (651) 241-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1407318553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023828",
            "telephone_number": "651-758-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 CITY CENTRE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253323",
            "telephone_number": "651-731-0859",
            "fax_number": "651-731-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASHUSI",
        "first_name": "OLUSEYI",
        "middle_name": "O",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.