DR. WURAOLA IBIYEMI OMOTOSHO (MD) – Internal Medicine Physician, NPI 1427222884
Internal Medicine Physician
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NPPES metrics only — not quality of care.
8,824 INTERNAL MEDICINE in IL
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Provider Addresses for DR. WURAOLA IBIYEMI OMOTOSHO (MD)
656, North Convent Street, Bourbonnais, Kankakee County, Illinois, 60914, United States
#C
BOURBONNAIS, IL 609140000
Phone: (815) 936-5167
Fax: (815) 937-8246
Type: Location
1000, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States
SUITE 100
BOLINGBROOK, IL 604400000
Phone: (630) 914-2417
Fax: (630) 914-2499
Type: Mailing
656 N Convent
#C
Bourbonnais, IL 609140000
Phone: (815) 936-5167
Fax: (815) 937-8246
Type: Location
102 COMMERCE DR
CLIFTON, IL 609279501
Phone: (815) 694-2044
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: 2010-09-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20100903000740 | I | Internal Medicine | IL | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 424 | 296 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 335 | 234 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 110 | 110 | $0 |
| 83036 | Hemoglobin a1c level | 105 | 64 | $0 |
| G0008 | Administration of influenza virus vaccine | 41 | 41 | $0 |
Insurance plans in this area (ZIP 60914)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | IL | 83036 | Hemoglobin A1C level | 31 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| Internal Medicine, Gastroenterology | IN | |
| Internal Medicine | IL | |
| Family Practice | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | IL | |
| Internal Medicine | IL | |
| Family Practice | IL | |
| Internal Medicine, Emergency Medicine | MI | |
| Family Practice, Emergency Medicine | IL |
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