DR. OMOFOLARIN BABATUNJI FASUYI (M.D, M.P.H) – Family Medicine Physician, NPI 1104260090
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,330 FAMILY PRACTICE in MO
Provider Addresses for DR. OMOFOLARIN BABATUNJI FASUYI (M.D, M.P.H)
1605 MARTIN SPRINGS DR
SUITE 210
ROLLA, MO 654012982
Phone: (573) 458-6326
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $30.
Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.
Last reported payment date: 2024-05-01 • Largest payer in this snapshot: ViiV Healthcare Company ($30).
Total Amount
$30
General + Research + Ownership
Payments
1
Total payment records
General Amount
$30
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $30 |
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: 2019-12-09
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 |
|---|---|---|---|---|
| I20191209000951 | I | Family Practice | GA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 26 | 20 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 14 | 14 | $0 |
Insurance plans in this area (ZIP 65401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Infectious Disease, Internal Medicine | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| N E U R O L O G Y | CT | |
| P S Y C H I A T R Y | GA | |
| Cardiovascular Disease (Cardiology), Internal Medicine | GA | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | GA |
Reviews
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