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DR. MODUPE AGBEYOMI DNP, FNP-C
NPI 1245715903
Nurse Practitioner - Family in Brookhaven, GA

Active since September 28, 2018PECOS Enrolled
13 CORPORATE BLVD NE STE 200, BROOKHAVEN, GA 30329(770) 557-1079(770) 872-6621 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Modupe Agbeyomi Dnp, Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MODUPE AGBEYOMI DNP, FNP-C (NPI 1245715903) is an individual family provider in Brookhaven, Georgia, licensed in Georgia (F09180151) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245715903
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDR. MODUPE AGBEYOMICredential: DNP, FNP-C
Location Address13 CORPORATE BLVD NE STE 200Brookhaven, GA 30329-1900
Mailing Address13 Corporate Blvd Ne Ste 200Brookhaven, GA 30329-1900 · (770) 557-1079 · Fax (770) 872-6621
Phone(770) 557-1079
Fax(770) 872-6621
Sole ProprietorYes
Enumeration DateSeptember 28, 2018
Last NPPES UpdateNovember 29, 2023
NPPES CertifiedNovember 29, 2023
✔ NPI 1245715903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · F09180151
Also ListedHome InfusionTaxonomy 251F00000X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
Also ListedClinic/Center · Migrant HealthTaxonomy 261QM1000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License F09180151 (GA)
Also ListedNurse Practitioner · SchoolTaxonomy 363LS0200X · License F09180151 (GA)
13 CORPORATE BLVD NE STE 200, Brookhaven, GA 30329
Open in Google Maps ↗

Other Identifiers 1

MedicaidF09180151GA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Modupe Agbeyomi Dnp, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Modupe Agbeyomi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifeguide, Inc
12 mi
Primary Care
656 INDIAN TRAIL LILBURN RD NW STE 208
Lilburn, GA 30047
  • Reassigned Medicare billing, Georgia enrollment
NPI 1508078973 (770) 557-1079
Anemonefish Inpatient Services LLC
32 mi
Internal Medicine
5126 HOSPITAL DR NE
Covington, GA 30014
  • Reassigned Medicare billing, Georgia enrollment
  • 81 clinicians in this Medicare group
NPI 1033514716 (954) 939-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30329 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modupe Agbeyomi's NPI number?

The NPI number for Modupe Agbeyomi is 1245715903. It was assigned to this individual provider in the NPPES registry on September 28, 2018.

Where is Modupe Agbeyomi located?

Modupe Agbeyomi practices at 13 Corporate Blvd NE Ste 200, Brookhaven, GA 30329. The listed phone number is (770) 557-1079.

What is Modupe Agbeyomi's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Modupe Agbeyomi enrolled in Medicare?

Yes. Modupe Agbeyomi is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Modupe Agbeyomi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Modupe Agbeyomi reassigns Medicare benefits to 2 organizations: Lifeguide, Inc (Lilburn, GA) and Anemonefish Inpatient Services LLC (Covington, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Modupe Agbeyomi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Modupe Agbeyomi was last updated on November 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.