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DR. OSAYANDE STEPHEN IZEIYAMU MD
NPI 1255698619
General Practice in Lake City, FL

Active since April 23, 2012PECOS Enrolled
194 SW WALL TER, LAKE CITY, FL 32025(386) 719-9227(386) 719-9488 Get Directions Write a Review

NPPES record last updated: January 20, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Osayande Stephen Izeiyamu Md NPPES

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

DR. OSAYANDE STEPHEN IZEIYAMU MD (NPI 1255698619) is an individual general practice provider in Lake City, Florida, licensed in Florida (ACN634) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255698619
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. OSAYANDE STEPHEN IZEIYAMUCredential: MD
Location Address194 SW WALL TERLake City, FL 32025-5086
Mailing Address194 Sw Wall TerLake City, FL 32025-5086 · (386) 719-9227 · Fax (386) 719-9488
Phone(386) 719-9227
Fax(386) 719-9488
Sole ProprietorYes
Enumeration DateApril 23, 2012
Last NPPES UpdateJanuary 20, 2016
✔ NPI 1255698619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in FL · ACN634
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X · License BP10043366 (TX)
194 SW WALL TER, Lake City, FL 32025
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Other Identifiers 1

Medicaid014632400FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Osayande Stephen Izeiyamu Md 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 Reassignment

Medicare enrollment records show Osayande Izeiyamu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Origins Family Medical & Weight Loss Clinic Inc
0.8 mi
General Practice
206 S MARION AVE
Lake City, FL 32025
  • Reassigned Medicare billing, Florida enrollment
  • 4 clinicians in this Medicare group
NPI 1962835306 (386) 755-5014

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
15%175 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
1%292 patients1/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
3%107 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Osayande Izeiyamu's NPI number?

The NPI number for Osayande Izeiyamu is 1255698619. It was assigned to this individual provider in the NPPES registry on April 23, 2012.

Where is Osayande Izeiyamu located?

Osayande Izeiyamu practices at 194 SW Wall Ter, Lake City, FL 32025. The listed phone number is (386) 719-9227.

What is Osayande Izeiyamu's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Osayande Izeiyamu enrolled in Medicare?

Yes. Osayande Izeiyamu is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Osayande Izeiyamu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Osayande Izeiyamu reassigns Medicare benefits to Origins Family Medical & Weight Loss Clinic Inc (Lake City, FL). The 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 Osayande Izeiyamu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Osayande Izeiyamu accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Osayande Izeiyamu as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Osayande Izeiyamu was last updated on January 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.