Koyejo A. Oyerinde, M.D.
Individual provider Active NPI Pediatrics Physician · Minot, ND
NPI 1790952836 · NPPES record last updated Apr 20, 2017
Key facts
- NPI
- 1790952836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 13901 (ND)
- Practice address
- 2111 Landmark Cir
Minot, ND 58703-1967 - Phone
- (701) 858-1800
- Fax
- (701) 857-8056
- NPI assigned
- May 8, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND, OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151223000833 | ND | Practitioner - Pediatric Medicine | 5193945376 | Reassigns benefits to 1 organization |
| I20220630001672 | OH | Practitioner - Pediatric Medicine | 5193945376 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13901 | ND | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axess Family Services Inc | Current | Accepting new patients | |
| University Hospitals Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| Axess Family Services Inc | Current |
Accepting new patients | |
| St Alexius Medical Center | Current |
Accepting new patients | |
| St. Alexius Medical Center | Current |
Accepting new patients | |
| Axess Family Services Inc | Current |
Accepting new patients | |
| Axess Family Services Inc | Past | Accepting new patients | |
| Axess Family Services Inc | Past | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients |
Locations
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
2111 Landmark Cir NW
Minot, ND 58703
Phone (701) 857-8031
1400 S Arlington St
Unit 38
Akron, OH 44306
Phone (330) 724-5471
527 W Market St
Akron, OH 44303
Phone (330) 510-4747
390 Robinson Ave
Ste E
Barberton, OH 44203
Phone (330) 564-2697
5805 Euclid Ave
Fl 2
Cleveland, OH 44103
11100 Euclid Ave
Cleveland Heights, OH 44106
143 Gougler Ave
Kent, OH 44240
Phone (330) 673-1016
771 N Freedom St
Ravenna, OH 44266
Phone (330) 296-5552
150 E Market St
Warren, OH 44481
Phone (330) 394-6244
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13901 | ND | Yes |
Addresses
Primary practice location
2111 Landmark Cir
Minot, ND 58703-1967
Mailing address
PO Box 997
Bismarck, ND 58502-0997
Phone (701) 858-1800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1465948 | Medicaid | ND |
Other providers in Minot, ND
- Ifeoma Osuala
- Lynae Osvold
- Michelle Otto
- Akira Owen
- Oluremilekun Oyefolu
- Danial Padgett
- Megan Padron
- McKenzie Olivia Page
- Jade Pakkala
- Stephanie Diane Palmer
All providers in Minot, ND · Pediatrics Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.