NPIMap

Individual provider Active NPI

Ifeloluwa A Olutola, MD

  • Family Medicine Physician
  • Tomah, WI
National Provider Identifier
1467065748
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
81543 Issued in WI
Practice address
325 Butts Ave
Tomah, WI 54660-1412
Phone
(608) 785-0940
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN31904 FL
Family Medicine Physician 207Q00000X 81543 WI Primary

Addresses

Primary practice location

325 Butts Ave
Tomah, WI 54660-1412

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (608) 785-0940

Other practice location 1

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iolutola1221351@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002569 WI Practitioner - Family Practice 1456778752 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN31904FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomah Memorial Hospital Inc CurrentSince Nov 1, 2025 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Sep 1, 2023 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Sep 1, 2023 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 7, 2023 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 7, 2023 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

325 Butts Ave
Tomah, WI 54660
Phone (608) 372-5951

Interoperability endpoints

  • Direct secure messaging: iolutola547584@direct.shands.ufl.edu
  • Direct secure messaging: iolutola821563@direct.emplifyhealth.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 13

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

View all 13

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
Tomah Memorial Hospital Inc 54 clinicians
Mayo Clinic Health System-Southwest Wisconsin Region Inc 539 clinicians

Practice addresses (Care Compare)

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

700 W Ave S
La Crosse, WI 54601-4783
Phone (608) 785-0940

Hospital & facility affiliations

  • Tomah Memorial Hospital Hospital, Tomah, WI, CCN 521320
  • Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004
  • Mayo Clinic HLTH Systm Franciscan Hlthcare Sparta Hospital, Sparta, WI, CCN 521305
  • Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
  • Tomah Memorial Hospital Nursing home, CCN 52Z320

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1467065748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 BUTTS AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601412",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLUTOLA",
        "first_name": "IFELOLUWA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN31904",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "81543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iolutola1221351@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "325 Butts Ave",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546601412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.