Individual provider Active NPI

Olubukola O Oni, MD

  • Family Medicine Physician
  • Kenmare, ND
National Provider Identifier
1912137449
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12267 Issued in ND
Practice address
309 1St Ave W
Kenmare, ND 58746
Phone
(701) 385-4283
Fax
(701) 385-4282
NPI assigned
Jul 17, 2009
Last updated
Jan 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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 12267 ND Primary

Addresses

Primary practice location

309 1St Ave W
Kenmare, ND 58746

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650

Other identifiers 1

IdentifierTypeStateIssuer
17209MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20121130000391 ND Practitioner - Family Practice 0042462889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

1500 21St Ave NW
Suite 102
Minot, ND 58703-0867
Phone (701) 418-4300

3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300

801 21St Ave SE
Minot, ND 58701-6064
Phone (701) 838-3150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12267NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince May 4, 2017 Accepting new patients
Sanford Bismarck Family Medicine CurrentSince May 4, 2017 Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

801 21st Ave SE
Minot, ND 58701
Phone (701) 838-3033

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1912137449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5650",
            "fax_number": "701-857-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 1ST AVE W",
            "city": "KENMARE",
            "state": "ND",
            "postal_code": "58746",
            "telephone_number": "701-385-4283",
            "fax_number": "701-385-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONI",
        "first_name": "OLUBUKOLA",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "12267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17209",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmare, ND

Sources for this page

Verify at the official NPI Registry.