Individual provider Active NPI

Oluwatobi Ganiu Lasisi, MD

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1790429686
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101284975 Issued in VA
Practice address
3650 Joseph Siewick Dr Ste 400
Fairfax, VA 22033-1715
Phone
(703) 391-2020
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0101924 MD
Family Medicine Physician 207Q00000X 0101284975 VA Primary

Addresses

Primary practice location

3650 Joseph Siewick Dr Ste 400
Fairfax, VA 22033-1715

Mailing address

Howard University Hospital 2041 Georgia Avenue NW
Washington, DC 20060-0001

Other practice location 1

1110 Annapolis Rd
Odenton, MD 21113-1602
Phone (443) 351-3917

Other practice location 2

3650 Joseph Siewick Dr Ste 203
Fairfax, VA 22033-1712
Phone (703) 391-2020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MDExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20241213001238 DC Practitioner - Family Practice 4587190525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Physician Partners LLCGroup PAC ID 2466581772, 258 clinicians

Practice addresses (Care Compare)

3650 Joseph Siewick Dr
Suite 400
Fairfax, VA 22033-1715
Phone (703) 391-2020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0101924MDMDFamily Medicine Physician
0101284975VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jul 7, 2025 Accepting new patients
Patient First Maryland Medical Group PLLC Family Medicine CurrentSince Oct 15, 2024 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

8206 Georgia Ave
Silver Spring, MD 20910
Phone (301) 960-4682

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

3650 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 391-2020

3650 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-2020

3650 Joseph Siewick Dr
Ste 101
Fairfax, VA 22033
Phone (703) 391-0900

3650 Joseph Siewick Dr
Ste 203
Fairfax, VA 22033
Phone (703) 391-1500

Interoperability endpoints

  • Direct secure messaging: mdexchange@patientfirstclinics.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1790429686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HOWARD UNIVERSITY HOSPITAL 2041 GEORGIA AVENUE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331715",
            "telephone_number": "703-391-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 Annapolis Rd",
            "address_purpose": "LOCATION",
            "city": "Odenton",
            "state": "MD",
            "postal_code": "211131602",
            "country_code": "US",
            "telephone_number": "443-351-3917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3650 Joseph Siewick Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331712",
            "country_code": "US",
            "telephone_number": "703-391-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASISI",
        "first_name": "OLUWATOBI",
        "middle_name": "GANIU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0101924",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101284975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1110 Annapolis Rd",
            "city": "Odenton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211131602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.