Patricia Ayoola Oyetakin, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

96680 Issued in GA

Practice address

5730 Glenridge Dr Ste T100
Atlanta, GA 30328-5747

Phone

(404) 939-9220

Fax

(470) 312-2157

NPI assigned

Jul 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Patricia Ayoola Oyetakin-White Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Dermatology

Education

Wayne State University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology of Georgia, LLCGroup PAC ID 6800798182, 22 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: poyetakin14228@wellspan.direct-ci.com

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.

• Epiphany Dermatology of Georgia, LLC

  • Dermatology Physician
  • Fayetteville, GA
  • NPI 1265544357
  Medicare reassignment Care Compare group NPD
• Medical Dermatology Specialists,PC

  • Medical Specialty Clinic/Center
  • Sandy Springs, GA
  • NPI 1134544679
  Medicare reassignment NPD

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1740592575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR STE T100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285747",
            "telephone_number": "404-939-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR STE T100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285747",
            "telephone_number": "404-939-9220",
            "fax_number": "470-312-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYETAKIN",
        "first_name": "PATRICIA",
        "middle_name": "AYOOLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "96680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "OYETAKIN-WHITE",
            "middle_name": "AYOOLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adejoke O Oyeniya, AGACNP-BC
• Abayomi Oyenuga
• Mosunmoluwa Oyenuga, MD
• Esther Oluwadamilola Oyerinde
• Nelson M Oyesiku, MD
• Abraham A Oyewo, MD
• Agnes Pukande Oyewo, FNP-C
• Oluwabukunmi Elijah Oyewole, RPH
• Oluwabusayo Oyewole
• Comfort Oyeyemi

• Dermatology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.