Individual provider Active NPI

Olatokunbo Olaniyi Elemide, M.D

  • Internal Medicine Physician
  • Alexandria, VA
National Provider Identifier
1609187848
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101254766 Issued in VA
Practice address
2501 Parkers LN
Alexandria, VA 22306-3209
Phone
(703) 664-7000
Fax
(703) 664-7666
NPI assigned
Jun 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0101254766 VA
Student in an Organized Health Care Education/Training Program 390200000X DC
Internal Medicine Physician 207R00000X 0101254766 VA Primary

Addresses

Primary practice location

2501 Parkers LN
Alexandria, VA 22306-3209

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Other practice location 2

2041 Georgia Ave NW
Washington, DC 20060-0001
Phone (202) 865-6100

Other practice location 3

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Other practice location 4

2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153
Phone (757) 934-4821

Other identifiers 1

IdentifierTypeStateIssuer
1609187848MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20140123001297 VA Practitioner - HospitalistPractitioner - Internal Medicine 4981832789 Reassigns benefits to 4 organizations
I20210907000692 DC Practitioner - HospitalistPractitioner - Internal Medicine 4981832789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

111 Mill Creek Pkwy
Suite 300
Chesapeake, VA 23323-1098
Phone (757) 558-8210

2800 Godwin Blvd
Suite 240
Suffolk, VA 23434-8038
Phone (757) 934-4550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101254766VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Aug 16, 2021 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince Aug 16, 2021 Accepting new patients
Sentara Medical Group Internal Medicine CurrentSince Dec 3, 2013 Accepting new patients
Inova Health Care Services CurrentSince Aug 16, 2021 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7700 E Parham Rd
Richmond, VA 23294
Phone (804) 289-4852

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

2790 Godwin Blvd
Ste 360
Suffolk, VA 23434
Phone (757) 539-3911

2800 Godwin Blvd
Ste 240
Suffolk, VA 23434
Phone (757) 934-4550

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1609187848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PARKERS LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063209",
            "telephone_number": "703-664-7000",
            "fax_number": "703-664-7666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200600001",
            "country_code": "US",
            "telephone_number": "202-865-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6000",
            "fax_number": "703-858-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2790 Godwin Blvd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348153",
            "country_code": "US",
            "telephone_number": "757-934-4821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELEMIDE",
        "first_name": "OLATOKUNBO",
        "middle_name": "OLANIYI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101254766",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101254766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609187848",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.