Oyeyemi Anthony Shodiya

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209025058 Issued in IL

Practice address

15928 Leclaire Ave Apt A206
Oak Forest, IL 60452-3911

Phone

(708) 864-1818

NPI assigned

Feb 28, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiorenal Therapeutics of Illinois PLLCGroup PAC ID 5395159677, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Cardiorenal Therapeutics of Illinois PLLC

  • Nephrology Physician
  • Oakbrook Terrace, IL
  • NPI 1336752682

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Midwest Post Acute Care PLLC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1083012074

  Multi-Specialty

  Medicare reassignment NPD
• Sandeep Chandra MD SC

  • Internal Medicine Physician
  • Burbank, IL
  • NPI 1407897218

  Multi-Specialty

  Medicare reassignment NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452

  Multi-Specialty

  Medicare reassignment NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  IL, Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1841946944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15928 LECLAIRE AVE APT A206",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523911",
            "telephone_number": "708-864-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15928 LECLAIRE AVE APT A206",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523911",
            "telephone_number": "708-864-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHODIYA",
        "first_name": "OYEYEMI",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041463053",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209025058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila M. Vacendak, DDS, PC
• Mindy Jo Sherack, LCSW
• Sherry Petro & Assoc
• Darshana J Sheth, MD
• Veeral Sheth, M.D.
• Kareema Siddiqui
• Erica Sidenstick, LSW, CADC
• Ranjit Sigamony, M.D
• Vladislav Souboch, OD
• South Suburban Multi Specialty Group LTD (South Subrban Multi Specialty Group LTD)

• Gerontology Nurse Practitioner in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.