OLUWASEUN OGUNSUYI OGUNTOMOLE
NPI 1356145072
Family Medicine in Jackson, MI

Q: What is Oluwaseun Oguntomole's NPI number?

The NPI number for Oluwaseun Oguntomole is 1356145072. It was assigned to this individual provider in the NPPES registry on April 2, 2025.

Q: What is Oluwaseun Oguntomole's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 02, 2025PECOS Enrolled

205 N EAST AVE, JACKSON, MI 49201(517) 205-3998(517) 205-7050 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Oluwaseun Ogunsuyi Oguntomole NPPES

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

OLUWASEUN OGUNSUYI OGUNTOMOLE (NPI 1356145072) is an individual family medicine provider in Jackson, Michigan, licensed in Michigan (4351054019) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356145072

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameOLUWASEUN OGUNSUYI OGUNTOMOLE

Location Address205 N EAST AVEJackson, MI 49201-1753

Mailing Address1630 Wells Branch Pkwy Apt 1335Austin, TX 78728-7173 · (504) 875-7010

Phone(517) 205-3998

Fax(517) 205-7050

Sole ProprietorNo

Enumeration DateApril 2, 2025

NPPES CertifiedApril 2, 2025

✔ NPI 1356145072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4351054019

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

205 N EAST AVE, Jackson, MI 49201

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Oluwaseun Ogunsuyi Oguntomole 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49201 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA RENE DANEK PA-C

Physician Assistant