Individual provider Active NPI

Oluwabunmi D. Adebayo, APRN

  • Family Nurse Practitioner
  • Rochester Hills, MI
National Provider Identifier
1922650787
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F05190099 Issued in MI
Practice address
800 W Avon Rd
Rochester Hills, MI 48307-2704
Phone
(248) 218-2000
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704297840 MI
Critical Care Medicine Registered Nurse 163WC0200X 000012459474 MI
Acute Care Nurse Practitioner 363LA2100X 2018078420 MI
Family Nurse Practitioner 363LF0000X F05190099 MI Primary

Addresses

Primary practice location

800 W Avon Rd
Rochester Hills, MI 48307-2704

Mailing address

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 218-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20260623001072 CA Practitioner - Nurse Practitioner 4789000522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12464 Benton Dr
Unit 2
Rancho Cucamonga, CA 91739-8097

12464 Benton Dr Unit
Suite 2
Rancho Cucamonga, CA 91739-8097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704297840MIMDRegistered Nurse
000012459474MIMDCritical Care Medicine Registered Nurse
2018078420MIMDAcute Care Nurse Practitioner
F05190099MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evidence Health LLC Current Accepting new patients
Telemed Consultants PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1922650787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-218-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W AVON RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072704",
            "telephone_number": "248-218-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEBAYO",
        "first_name": "OLUWABUNMI",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704297840",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "000012459474",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "2018078420",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F05190099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.