Individual provider Active NPI

Oluwadamilola Ejike, MD

  • Pediatric Nephrology Physician
  • Gainesville, FL
National Provider Identifier
1841633823
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
ME171197 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3108
Phone
(352) 265-0301
NPI assigned
Apr 9, 2013
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S0869 TX
Pediatric Nephrology Physician 2080P0210X 036-164064 IL
Pediatric Nephrology Physician 2080P0210X S0869 TX
Pediatric Nephrology Physician 2080P0210X ME171197 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3108

Mailing address

PO Box 100296
Gainesville, FL 32610-0296
Phone (352) 627-9350

Other practice location 1

333 N Santa Rosa
San Antonio, TX 78207-3108
Phone (210) 704-3030

Other practice location 2

9555 S 52nd Ave
Oak Lawn, IL 60453-3054
Phone (708) 684-5437

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address oejike372097@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL, TN, FL, MN5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20190826003156 TX Practitioner - Pediatric MedicinePractitioner - Nephrology 3971831140 Reassigns benefits to 1 organization
I20230522001316 IL Practitioner - Pediatric Medicine 3971831140 Reassigns benefits to 1 organization
I20241121000823 TN Practitioner - NephrologyPractitioner - Pediatric Medicine 3971831140 Reassigns benefits to 1 organization
I20241203003554 FL Practitioner - Pediatric Medicine 3971831140 Reassigns benefits to 1 organization
I20251103000179 MN Practitioner - Nephrology 3971831140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Nephrology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 0648405738, 36 clinicians

Practice addresses (Care Compare)

333 N Santa Rosa
San Antonio, TX 78207-3108
Phone (210) 704-4849

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME171197FLMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
Fairview Express Care Current Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Nov 14, 2024 Accepting new patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatrics CurrentSince Sep 2, 2024 Accepting new patients
Baylor College of Medicine Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 5, 2023 Accepting new patients
Fairview Express Care CurrentSince Nov 21, 2025 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Nov 14, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 5, 2023 Accepting new patients
Fairview Express Care CurrentSince Nov 21, 2025 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Interoperability endpoints

  • Direct secure messaging: oejike420660@christushealth.direct-ci.net
  • Direct secure messaging: oejike67944@mlh.direct-ci.com
  • Direct secure messaging: oejike744918@direct.shands.ufl.edu

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1841633823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100296",
            "telephone_number": "352-627-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103108",
            "telephone_number": "352-265-0301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Santa Rosa",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073108",
            "country_code": "US",
            "telephone_number": "210-704-3030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9555 S 52nd Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533054",
            "country_code": "US",
            "telephone_number": "708-684-5437",
            "fax_number": "708-876-1569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EJIKE",
        "first_name": "OLUWADAMILOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S0869",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": "036-164064",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "S0869",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "FL",
            "license": "ME171197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oejike372097@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.