NPIMap

Individual provider Active NPI

Taiwo Agnes Falaiye, MD

  • Family Medicine Physician
  • Michigan City, IN
National Provider Identifier
1942864871
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01091007A Issued in IN
Practice address
3012 Franklin St
Michigan City, IN 46360-6144
Phone
(219) 877-3841
NPI assigned
Apr 25, 2019
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 01091007A IN Primary

Addresses

Primary practice location

3012 Franklin St
Michigan City, IN 46360-6144

Mailing address

3012 Franklin St
Michigan City, IN 46360-6144
Phone (219) 877-3841

Other names 1

  • Taiwo Agnes Oyedeji Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002993 IN Practitioner - Family Practice 0749515757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

104 E Culver Rd
Knox, IN 46534-2241

3012 Franklin St
Michigan City, IN 46360-6144
Phone (219) 877-3841

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.68 of 100Reported as apm
Quality
76.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01091007AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Porte Clinic Company LLC CurrentSince Oct 1, 2023 Accepting new patients
La Porte Clinic Company LLC Family Medicine CurrentSince Oct 1, 2023 Accepting new patients
Porter Physician Services LLC Family Medicine Past Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Past Accepting new patients

Locations

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

401 Newport Blvd
Laporte, IN 46350
Phone (219) 326-1775

3012 Franklin St
Michigan City, IN 46360
Phone (219) 877-3841

3777 N Frontage Rd
Ste 500
Michigan City, IN 46360
Phone (219) 809-2889

6923 W 400 N
Michigan City, IN 46360
Phone (219) 325-0604

Organizations & group practices 5

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 4

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1942864871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606144",
            "telephone_number": "219-877-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606144",
            "telephone_number": "219-877-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALAIYE",
        "first_name": "TAIWO",
        "middle_name": "AGNES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2024-07-11",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01091007A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAIWO",
            "last_name": "OYEDEJI",
            "middle_name": "AGNES",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.