Individual provider Active NPI

A. O'Tayo Lalude, M.D.

  • General Practice Physician
  • Henderson, NV
National Provider Identifier
1912951419
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21661 Issued in KY
Practice address
304 Lindbrook St
Henderson, NV 89074-5087
Phone
(502) 494-1725
NPI assigned
May 19, 2006
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21661 KY
General Practice Physician 208D00000X 21661 KY Primary

Addresses

Primary practice location

304 Lindbrook St
Henderson, NV 89074-5087

Mailing address

304 Lindbrook St
Henderson, NV 89074-5087
Phone (502) 494-1725

Other identifiers 1

IdentifierTypeStateIssuer
64216617MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20081203000589 KY Practitioner - Family Practice 1456412824 Reassigns benefits to 1 organization
I20230612003241 CA Practitioner - General Practice 1456412824 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of California, PC General Practice CurrentSince May 3, 2023 Accepting new patients
Signify Health, LLC General Practice CurrentSince Jun 1, 2023 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1912951419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 LINDBROOK ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745087",
            "telephone_number": "502-494-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 LINDBROOK ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745087",
            "telephone_number": "502-494-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALUDE",
        "first_name": "A. O'TAYO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "21661",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "21661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64216617",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.