Dr Omolola Ajoke Omotoso, MD - Medicare Internal Medicine in Moncks Corner, SC

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Dr Omolola Ajoke Omotoso, MD is a medicare enrolled "Internal Medicine" physician in Moncks Corner, South Carolina. She graduated from medical school in 1999 and has 25 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Hospital Physician Services - Southeast Professional Corporation, Mercy Clinic Joplin Llc, Hannibal Regional Healthcare System Inc and her current practice location is 110 Executive Parkway, Moncks Corner, South Carolina. You can reach out to her office (for appointments etc.) via phone at (843) 899-9099.

Dr Omolola Ajoke Omotoso is licensed to practice in Georgia (license number 063694) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1154514529.

Contact Information

Dr Omolola Ajoke Omotoso, MD
110 Executive Parkway,
Moncks Corner, SC 29461
(843) 899-9099
(843) 899-9091

Map and Direction




Physician's Profile

Full NameDr Omolola Ajoke Omotoso
GenderFemale
SpecialityInternal Medicine
Experience25 Years
Location110 Executive Parkway, Moncks Corner, South Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Omolola Ajoke Omotoso graduated from medical school in 1999
  NPI Data:
  • NPI Number: 1154514529
  • Provider Enumeration Date: 08/20/2007
  • Last Update Date: 10/28/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 4183781420
  • Enrollment ID: I20140716002105

Medical Identifiers

Medical identifiers for Dr Omolola Ajoke Omotoso such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154514529NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine MT185765 (Pennsylvania)Secondary
207R00000XInternal Medicine 31061 (South Carolina)Secondary
208M00000XHospitalist 2016004893 (Missouri)Secondary
207R00000XInternal Medicine 063694 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Hannibal Regional HospitalHannibal, MOHospital
Mercy Hospital JoplinJoplin, MOHospital
Mayo Clinic Health System In WaycrossWaycross, GAHospital
Blessing HospitalQuincy, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Hospital Physician Services - Southeast Professional Corporation5597774554640
Mercy Clinic Joplin Llc0547300196247
Hannibal Regional Healthcare System Inc1254236300199

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Omolola Ajoke Omotoso allows following entities to bill medicare on her behalf.
Entity NameTift Regional Health System, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790280857
PECOS PAC ID: 5193619971
Enrollment ID: O20040212000064
Entity NameHospital Physician Services - Southeast Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760410385
PECOS PAC ID: 5597774554
Enrollment ID: O20060419000545
Entity NameApogee Medical Group Georgia
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629025143
PECOS PAC ID: 4587676945
Enrollment ID: O20060629000214
Entity NameWalker Lake Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003385964
PECOS PAC ID: 3870832843
Enrollment ID: O20190308002530

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Omolola Ajoke Omotoso is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Omolola Ajoke Omotoso, MD
P.o. Box 1116,
Moncks Corner, SC 29461

Ph: (843) 899-9099		Dr Omolola Ajoke Omotoso, MD
110 Executive Parkway,
Moncks Corner, SC 29461

Ph: (843) 899-9099

Reviews and Comments


Internal Medicine Doctors in Moncks Corner, SC

Dr. Michael Eugene Field, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 3508 S Live Oak Dr, Moncks Corner, SC 29461
Phone: 843-534-1770    Fax: 877-453-3943
Rose Delores Gibbs, MD
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 106 W Main St, Moncks Corner, SC 29461
Phone: 843-761-1995    Fax: 843-761-3257
Dr. Temisan L Etikerentse, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 110 Executive Pkwy, Moncks Corner, SC 29461
Phone: 843-899-9099    Fax: 843-899-9091

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.