Individual provider Active NPI

Oladipupo O Osunbunmi, M.D.

  • Family Medicine Physician
  • Rantoul, IL
National Provider Identifier
1558931634
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036168496 Issued in IL
Practice address
1540 E Grove Ave
Rantoul, IL 61866-2736
Phone
(217) 893-7700
Fax
(217) 893-7801
NPI assigned
Jun 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036168496 IL Primary

Addresses

Primary practice location

1540 E Grove Ave
Rantoul, IL 61866-2736

Mailing address

1540 E Grove Ave
Rantoul, IL 61866-2736
Phone (217) 893-7700

Other practice location 1

102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379
Phone (217) 872-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20240718004555 IL Practitioner - Family Practice 0345642237 Reassigns benefits to 1 organization

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
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1540 E Grove Ave
Rantoul, IL 61866-2736
Phone (217) 893-7700

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036168496ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Family Medicine CurrentSince Jul 8, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

1540 E Grove Ave
Rantoul, IL 61866
Phone (217) 893-7700

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: oosunbunmimd413896@carlehiedirect.net

Organizations & group practices 3

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 3

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1558931634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E GROVE AVE",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618662736",
            "telephone_number": "217-893-7700",
            "fax_number": "217-893-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E GROVE AVE",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618662736",
            "telephone_number": "217-893-7700",
            "fax_number": "217-893-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 W Kenwood Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264379",
            "country_code": "US",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSUNBUNMI",
        "first_name": "OLADIPUPO",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036168496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rantoul, IL

Sources for this page

Verify at the official NPI Registry.