Individual provider Active NPI

Olufisayo Kabirat Ololade, MD

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1811569494
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5315224752 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-5710
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5315224752 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

1200 E Michigan Ave Ste 245
Lansing, MI 48912-1897
Phone (517) 364-5710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241119000185 NY Practitioner - Pediatric Medicine 1153856877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315224752MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 13, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Sep 13, 2024 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: oololade@montefioredirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1811569494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 245",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121897",
            "telephone_number": "517-364-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOLADE",
        "first_name": "OLUFISAYO",
        "middle_name": "KABIRAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5315224752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.