NPIMap

Individual provider Active NPI

Tolulope Oyebola Fadayomi, MD

  • Internal Medicine Physician
  • Cape Girardeau, MO
National Provider Identifier
1760942411
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2024036714 Issued in MO
Practice address
1702 N Kingshighway St
Cape Girardeau, MO 63701-2122
Phone
(573) 339-2000
Fax
(573) 339-1876
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2024036714 MO Primary
Pediatrics Physician 208000000X 2024036714 MO

Addresses

Primary practice location

1702 N Kingshighway St
Cape Girardeau, MO 63701-2122

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other names 1

  • Tolulope Oyebola Ifabiyi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20241001001722 MO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3577897974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oakland Univ, William Beaumont School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians
Immediate Convenient Care LLCGroup PAC ID 0648313486, 23 clinicians

Practice addresses (Care Compare)

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

1702 N Kingshighway
Cape Girardeau, MO 63701-2122

1702 N Kingshighway St
Cape Girardeau, MO 63701-2122

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024036714MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Laboratory & Pathology, LC Current Accepting new patients
The Metrohealth System Current Accepting new patients
Saint Francis Medical Center Internal Medicine CurrentSince Oct 21, 2024 Accepting new patients
Saint Francis Medical Center CurrentSince Oct 21, 2024 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center Internal Medicine Past Accepting new patients

Locations

1702 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 339-0483

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

Interoperability endpoints

  • Direct secure messaging: tifabiyi109597@surescripts.sfmc.net
  • Direct secure messaging: tifabiyi261660@direct.metrohealth.org

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 and National Provider Directory roles.

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1760942411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012122",
            "telephone_number": "573-339-2000",
            "fax_number": "573-339-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAYOMI",
        "first_name": "TOLULOPE",
        "middle_name": "OYEBOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2024036714",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2024036714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOLULOPE",
            "last_name": "IFABIYI",
            "middle_name": "OYEBOLA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.