CALEB IFEOLUWA OLUWADAMISI (M.D) – Family Medicine Physician, NPI 1366064560
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,041 FAMILY PRACTICE in IL
Provider Addresses for CALEB IFEOLUWA OLUWADAMISI (M.D)
JAVON BEA HOSPITAL - ROCKTON AVENUE
2400 N ROCKTON AVENUE
ROCKFORD, IL 61103
Phone: (815) 971-5000
Type: Mailing
MERCY HEALTH JAVON BEA HOSPITAL
8201 EAST RIVERSIDE BOULEVARD
ROCKFORD, IL 61114
Phone: (815) 971-5000
Type: Location
308 N MAPLE AVE
NEW HAMPTON, IA 506591142
Phone: (641) 394-2151
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230803002713 | I | Emergency Medicine | IA | TBD |
| I20251008003525 | I | Family Practice | IL | TBD |
| I20251023003754 | I | Family Practice | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 63 | 40 | $0 |
Insurance plans in this area (ZIP 61103)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WI | |
| Emergency Medicine | MN | |
| Emergency Medicine | FL | |
| Emergency Medicine | IL | |
| Emergency Medicine | WI | |
| Family Practice, Emergency Medicine | IA | |
| Emergency Medicine, Family Practice | IA | |
| Emergency Medicine, Internal Medicine, Emergency Medicine | TN | |
| Emergency Medicine | IA | |
| Emergency Medicine, Family Practice | IA |
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