Tajudeen Oladapo Fawole, M. D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46351 Issued in MN

Practice address

4808 85TH Ave N
Brooklyn Park, MN 55443-1816

Phone

(763) 496-1562

Fax

(763) 657-0581

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Internal MedicineAlso: Geriatric Medicine, Hospice/Palliative Care

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regency Hospital of Minneapolis, LLCGroup PAC ID 0345203840, 22 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.

• Regency Hospital of Minneapolis, LLC

  • Long Term Care Hospital
  • Golden Valley, MN
  • NPI 1770585382
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1801991005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 85TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431816",
            "telephone_number": "763-496-1562",
            "fax_number": "763-657-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 85TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431816",
            "telephone_number": "763-496-1562",
            "fax_number": "763-657-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWOLE",
        "first_name": "TAJUDEEN",
        "middle_name": "OLADAPO",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "46351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdullahi Mohamed Farah
• Hamdi Ahmed Farah
• Hayat Farah
• Esther Gobah Fares
• Kathleen Faust, MSE, LPCC
• Feller Chiropractic
• Marshall K. Feller, D.C.
• Lindsay Fiedler-Schiel, LPCC
• Fields Home Services, LLC
• First Choice Nursing and Home Care, Inc.

• Internal Medicine Physician in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.