Individual provider Active NPI

Olumide A Danisa, MD

  • Orthopaedic Surgery of the Spine Physician
  • Durham, NC
National Provider Identifier
1467413450
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G89015 Issued in CA
Practice address
40 Duke Medicine Cir
Durham, NC 27710-4000
Phone
(919) 618-2735
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 2024-01972 NC
Orthopaedic Surgery of the Spine Physician 207XS0117X G89015 CA Primary

Addresses

Primary practice location

40 Duke Medicine Cir
Durham, NC 27710-4000

Mailing address

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 618-2735

Other practice location 1

2006 Health Campus Dr
Harrisonburg, VA 22801-8679
Phone (540) 689-5500

Other practice location 2

25455 Barton Rd Ste 102B
Loma Linda, CA 92354
Phone (909) 558-2808

Other identifiers 1

IdentifierTypeStateIssuer
1467413450MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 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
I20120302000346 CA Practitioner - Orthopedic Surgery 0648183871 Reassigns benefits to 2 organizations
I20240820003025 NC Practitioner - Orthopedic Surgery 0648183871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Virginia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

30 Duke Medicine Cir
Durham, NC 27710-3000
Phone (919) 684-8111

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion54
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G89015CAMDOrthopaedic Surgery of the Spine Physician
2024-01972NCMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2012 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2012 Accepting new patients
Beaver Medical Group P C CurrentSince May 12, 2012 Accepting new patients
Beaver Medical Group P C CurrentSince May 12, 2012 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Piedmont Henry Hospital, Inc. Past Accepting new patients
Piedmont Hospital, Inc Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Fayette Community Hospital, Inc. Past Accepting new patients
Southern Regional Health System, Inc Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Orthopaedic Surgery of the Spine Past Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients

Locations

900 E Washington St
Ste 200
Colton, CA 92324
Phone (909) 882-5867

25455 Barton Rd
Loma Linda, CA 92354
Phone (909) 558-2808

11406 Loma Linda Dr
Ste 300
Loma Linda, CA 92354
Phone (909) 558-6277

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

25455 Barton Rd
Ste 102B
Loma Linda, CA 92354
Phone (909) 558-2808

11370 Anderson St
Ste 1500
Loma Linda, CA 92354
Phone (909) 558-2802

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

2 W Fern Ave
#1112
Redlands, CA 92373

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

30 Duke Medicine Cir
Durham, NC 27710
Phone (919) 421-8158

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: odanisa575064@direct.medicine.duke.edu

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 8

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1467413450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277104000",
            "telephone_number": "919-618-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277104000",
            "telephone_number": "919-618-2735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2006 Health Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228018679",
            "country_code": "US",
            "telephone_number": "540-689-5500",
            "fax_number": "540-689-5501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25455 Barton Rd Ste 102B",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "92354",
            "country_code": "US",
            "telephone_number": "909-558-2808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANISA",
        "first_name": "OLUMIDE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NC",
            "license": "2024-01972",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G89015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467413450",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.