Sylveria Oluwatosin Olatidoye, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

048687 Issued in GA

Practice address

1125 Towne Centre Village Drive
Kaiser Permanente Henry Medical Center
McDonough, GA 30253

Phone

(678) 583-6579

NPI assigned

Jul 20, 2006

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

• Sylveria Oluwatosin Munis Former name

Electronic endpoints 1

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

Family Practice

Education

West Virginia University School of Medicine, 1991

Medicare assignment

May accept Medicare assignment

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Matrix Rehabilitation-Georgia IncGroup PAC ID 2567379498, shared by 4 NPIs, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1780604389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "BLD NINE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051773",
            "telephone_number": "404-364-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 TOWNE CENTRE VILLAGE DRIVE",
            "address_2": "KAISER PERMANENTE HENRY MEDICAL CENTER",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "678-583-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATIDOYE",
        "first_name": "SYLVERIA",
        "middle_name": "OLUWATOSIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "048687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1125 Towne centre village drive",
            "address_2": "Kaiser permanente Henry Medical center",
            "city": "mcdonough",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SYLVERIA",
            "last_name": "MUNIS",
            "middle_name": "OLUWATOSIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa D Ogletree
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• Rosemary Oke
• Ruby Okoh
• Williemae Okwandu, OWNER/ADMINISTRATOR
• Stacy Michael Olliff, M.D.
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• Onekey Medical Staffing
• Chinonyerem Ijeoma Onor, OD
• Open Arms EMS

• Family Medicine Physician in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.