Olatunji Jonathan Oluwatade, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

19904 Issued in MS

Practice address

2080 S, Frontage Rd.
Suite100
Vicksburg, MS 39180-5883

Phone

(601) 262-1000

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Dr. Olatunji Jonathan Oguntade Former name

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Emergency MedicineAlso: Internal Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KCC Infusion, LLCGroup PAC ID 4688076896, 2 clinicians

Medical Associates of Vicksburg PLLCGroup PAC ID 3577782366, 8 clinicians

Revitalize Hydration Therapy LLCGroup PAC ID 5193154128, 8 clinicians

Copiah County Medical CenterGroup PAC ID 2062583487, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
• Centerwell Home Health Home health agency, Flowood, MS, CCN 257126
• Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
• Enhabit Home Health Home health agency, Vicksburg, MS, CCN 257097
• Adoration Home Health Home health agency, Vicksburg, MS, CCN 257103
• Merit Health River Region Hospital, Vicksburg, MS, CCN 250031
• Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Copiah County Medical Center Hospital, Hazlehurst, MS, CCN 251327
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• Baptist Memorial Rehabilitation Hospital-Madison Inpatient rehabilitation facility, Madison, MS, CCN 253028

Merit-based Incentive Payment System (MIPS)

Final score

95.2 of 100Reported as group

Quality

99.81

Improvement activities

40

Cost

72.06

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: olatunjioluwatade@fed2c3c7.micromddirect.com
• FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Heart of Hospice, LLC

  • Community Based Hospice Care Agency
  • Jackson, MS
  • NPI 1942731914

  Contracted Managing Employee

  CMS ownership

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.

• Copiah County Medical Center

  • Critical Access Hospital
  • Hazlehurst, MS
  • NPI 1588667281
  Medicare reassignment Care Compare group NPD
• KCC Infusion, LLC

  • Infusion Therapy Clinic/Center
  • Vicksburg, MS
  • NPI 1942875158
  Medicare reassignment Care Compare group NPD
• Medical Associates of Vicksburg PLLC

  • Internal Medicine Physician
  • Vicksburg, MS
  • NPI 1508278177
  Medicare reassignment Care Compare group NPD
• Revitalize Hydration Therapy, LLC

  • Gerontology Nurse Practitioner
  • Flowood, MS
  • NPI 1285261123
  Medicare reassignment Care Compare group NPD
• Baptist Medical Center - Yazoo, Inc

  • Critical Access Hospital
  • Yazoo City, MS
  • NPI 1619918075
  Medicare reassignment NPD
• Relias Emergency Medicine Specialists of West Point, LLC

  • Emergency Medicine Physician
  • West Point, MS
  • NPI 1275172736
  Medicare reassignment NPD
• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040

  Internal Medicine

  Medicare reassignment NPD
• South Sunflower County Hospital

  • General Acute Care Hospital
  • Indianola, MS
  • NPI 1184679292
  Medicare reassignment NPD
• St. Dominic Medical Associates LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1407920549
  Medicare reassignment NPD
• Vicksburg Healthcare LLC

  • Anesthesiology Physician
  • Vicksburg, MS
  • NPI 1629084058

  Emergency Medicine

  Medicare reassignment NPD
• Correct Care, Inc.

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1215987441

  MS

  Medicare reassignment NPD
• Wound Care Associates LLC

  • Specialist
  • Hammond, LA
  • NPI 1568793750

  MS

  Medicare reassignment NPD

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

• West Mississippi Home Health Services, Inc.

  • Home Health Agency
  • Vicksburg, MS
  • NPI 1649285016
  Care Compare affiliation Name & address match
• Amedisys Mississippi, LLC

  • Home Health Agency
  • Vicksburg, MS
  • NPI 1245288943
  Care Compare affiliation
• Baptist Memorial Rehabilitation Hospital - Madison LLC

  • Rehabilitation Hospital
  • Madison, MS
  • NPI 1457163156

  Inpatient rehabilitation facility

  Care Compare affiliation
• Copiah County Medical Center

  • Critical Access Hospital
  • Hazlehurst, MS
  • NPI 1588667281
  Care Compare affiliation
• Home Health Care Affiliates of Central Mississippi, LLC

  • Home Health Agency
  • Flowood, MS
  • NPI 1417935578
  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• Mississippi Homecare of Jackson II, LLC

  • Home Health Agency
  • Jackson, MS
  • NPI 1730373275
  Care Compare affiliation
• River Oaks Hospital LLC

  • General Acute Care Hospital
  • Flowood, MS
  • NPI 1396792032
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation
• Sta-Home Health Agency of Jackson, Inc.

  • Home Health Agency
  • Clinton, MS
  • NPI 1356482749
  Care Compare affiliation
• Vicksburg Healthcare LLC

  • General Acute Care Hospital
  • Vicksburg, MS
  • NPI 1215981303
  Care Compare affiliation

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1477677458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD",
            "address_2": "SUITE 100",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805328",
            "telephone_number": "601-262-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S, FRONTAGE RD.",
            "address_2": "SUITE100",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805883",
            "telephone_number": "601-262-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "971 Lakeland Dr Ste 954",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164609",
            "country_code": "US",
            "telephone_number": "601-200-4714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLUWATADE",
        "first_name": "OLATUNJI",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089363",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "19904",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "19904",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "19904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811254",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08108016",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLATUNJI",
            "last_name": "OGUNTADE",
            "middle_name": "JONATHAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Infectious Disease Physician in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Infectious Disease Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.