Individual provider Active NPI

Bisola Sarah Omoba, MD

  • Family Medicine Physician
  • Woodbury, MN
National Provider Identifier
1457921843
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18245 Issued in SD
Practice address
1825 Woodwinds Dr
Woodbury, MN 55125-2202
Phone
(651) 232-6700
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18245 SD Primary
Family Medicine Physician 207Q00000X 72270 MN
Family Medicine Physician 207Q00000X 84392-20 WI

Addresses

Primary practice location

1825 Woodwinds Dr
Woodbury, MN 55125-2202

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Other practice location 1

330 N 8th Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112

Other practice location 2

300 S Byron Blvd
Chamberlain, SD 57325-9741
Phone (605) 234-6551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20221014002055 MN Practitioner - Family Practice 3072916014 Reassigns benefits to 1 organization
I20260311003477 SD Practitioner - Family Practice 3072916014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72270MNMDFamily Medicine Physician
18245SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Feb 16, 2026 Accepting new patients
Sanford Health Network CurrentSince Feb 16, 2026 Accepting new patients
Healtheast Medical Research Institute Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Sanford Health Network CurrentSince Feb 16, 2026 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2024 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients

Locations

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

300 S Byron Blvd
Chamberlain, SD 57325
Phone (605) 234-5511

Interoperability endpoints

  • Direct secure messaging: bomoba1805454@fairview.direct-ci.com

Organizations & group practices 9

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 2

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1457921843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252202",
            "telephone_number": "651-232-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 N 8th Ave E",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052024",
            "country_code": "US",
            "telephone_number": "218-723-1112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 S Byron Blvd",
            "address_purpose": "LOCATION",
            "city": "Chamberlain",
            "state": "SD",
            "postal_code": "573259741",
            "country_code": "US",
            "telephone_number": "605-234-6551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOBA",
        "first_name": "BISOLA",
        "middle_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "18245",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "72270",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "84392-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.