Ololade Omitogun, is a medicare enrolled "Internal Medicine" physician in Lake Katrine, New York. She graduated from medical school in 2013 and has 13 years of diverse experience with area of expertise as Internal Medicine. Her current practice location is
300 Grant Ave, Lake Katrine, New York. You can reach out to her office (for appointments etc.) via phone at
(718) 709-0940.
Ololade Omitogun is licensed to practice in New York (license number P141024) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1225978703.
Physician's Profile
| Full Name | Ololade Omitogun |
|---|
| Gender | Female |
|---|
| Speciality | Internal Medicine |
|---|
| Experience | 13 Years |
|---|
| Location | 300 Grant Ave, Lake Katrine, New York |
|---|
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Ololade Omitogun graduated from medical school in 2013
NPI Data:
- NPI Number: 1225978703
- Provider Enumeration Date: 04/01/2026
- Last Update Date: 04/01/2026
Medicare PECOS Information:
- PECOS PAC ID: 1052886843
- Enrollment ID: I20260409000952
Medical Identifiers
Medical identifiers for Ololade Omitogun such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225978703 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | P141024 (New York) | Primary |
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. Ololade Omitogun allows following entities to bill medicare on her behalf.
| Entity Name | Fresh Meadows Physician Practice PLLC |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1720775083
PECOS PAC ID: 0941657811
Enrollment ID: O20231114003265 |
|---|
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. Ololade Omitogun 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 Address | Practice Location Address |
|---|
Ololade Omitogun,
3438 Bell Blvd,
Bayside, NY 11361-1739
Ph: (718) 709-0940 | Ololade Omitogun,
300 Grant Ave,
Lake Katrine, NY 12449-5340
Ph: (718) 709-0940 |
Reviews and Comments