Active NPI
Patrick Olamidotun Sobande, MD
- Pediatric Pulmonology Physician
- Dayton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 35.085674
- Practice address
- 1 Childrens PLZ
Dayton, OH 45404-1815 - Phone
- (937) 641-3376
- Fax
- (937) 641-4500
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | BS085674 | OH | |
| Pediatric Pulmonology Physician | 2080P0214X | 65599-20 | WI | |
| Pediatric Pulmonology Physician | 2080P0214X | 35.085674 | OH | Primary |
Addresses
Primary practice location
1 Childrens PLZ
Dayton, OH 45404-1815
Mailing address
PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072
Other practice location 1
3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-3376
Other practice location 2
1644 N Limestone St
Springfield, OH 45503-2652
Phone (937) 641-4000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 310833936 | Other | HUMANA | |
| 100012670 | Medicaid | IN | |
| 0307822 | Medicaid | OH | |
| 65901886 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BS085674 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dayton Children'S Specialty Physicians, Inc. | Pediatrics | Current | Accepting new patients |
| Dayton Children'S Specialty Physicians, Inc. | Pediatrics | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600
1010 Valley St
Dayton, OH 45404
Phone (937) 641-3023
967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330
3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400
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.
-
- Pediatrics Physician
- Dayton, OH
- NPI 1225192610
-
- Pediatrics Physician
- Dayton, OH
- NPI 1780467555
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1801846191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 933432",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441930039",
"telephone_number": "937-641-5072",
"fax_number": "937-641-5390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PLZ",
"city": "DAYTON",
"state": "OH",
"postal_code": "454041815",
"telephone_number": "937-641-3376",
"fax_number": "937-641-4500"
}
],
"practiceLocations": [
{
"address_1": "3333 W Tech Rd",
"address_purpose": "LOCATION",
"city": "Miamisburg",
"state": "OH",
"postal_code": "453420955",
"country_code": "US",
"telephone_number": "937-641-3376",
"fax_number": "937-641-4500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1644 N Limestone St",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "OH",
"postal_code": "455032652",
"country_code": "US",
"telephone_number": "937-641-4000",
"fax_number": "937-641-4500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOBANDE",
"first_name": "PATRICK",
"middle_name": "OLAMIDOTUN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "BS085674",
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "WI",
"license": "65599-20",
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "OH",
"license": "35.085674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "310833936",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100012670",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0307822",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65901886",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.