NPIMap

Individual provider Active NPI

Foluso A Fakorede, MD

  • Interventional Cardiology Physician
  • Cleveland, MS
National Provider Identifier
1679730329
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
23725 Issued in MS
Practice address
800 N Pearman Ave
Cleveland, MS 38732-3502
Phone
(888) 757-0838
Fax
(888) 757-1835
NPI assigned
May 20, 2008
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 23725 MS Primary

Addresses

Primary practice location

800 N Pearman Ave
Cleveland, MS 38732-3502

Mailing address

800 N Pearman Ave
Cleveland, MS 38732-3502
Phone (888) 757-0838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20150626001009 MS Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8325232838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Solutions of Central Ms, PAGroup PAC ID 8628374402, 2 clinicians

Practice addresses (Care Compare)

800 N Pearman Ave
Cleveland, MS 38732-3502
Phone (662) 545-5238

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.3 of 100Reported as individual
Quality
76.47
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)170

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23725MSMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Solutions of Central Ms PA Interventional Cardiology CurrentSince Oct 9, 2015 Accepting new patients
Fusion Vascular, LLC Interventional Cardiology CurrentSince Nov 26, 2018 Accepting new patients
Mid - South Heart Center PC Past Accepting new patients

Locations

3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683

800 N Pearman Ave
Cleveland, MS 38732
Phone (662) 545-5238

810 E Sunflower Rd
Ste 1005
Cleveland, MS 38732
Phone (662) 332-9872

903 E Sunflower Rd
Cleveland, MS 38732
Phone (888) 757-0838

Interoperability endpoints

  • Direct secure messaging: foluso_fakorede_md@yourcarecommunity.org
  • Direct secure messaging: foluso.fakorede.p1@direct.midsouthheartcenter.nextgenshare.com
  • Direct secure messaging: folusofakorede@cscm.allscriptsdirect.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1679730329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N PEARMAN AVE",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323502",
            "telephone_number": "888-757-0838",
            "fax_number": "888-757-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N PEARMAN AVE",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323502",
            "telephone_number": "888-757-0838",
            "fax_number": "888-757-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKOREDE",
        "first_name": "FOLUSO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "23725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

Verify at the official NPI Registry.