DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) – Critical Care Medicine (Internal Medicine) Physician, NPI 1164604138

DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) is a healthcare provider. based in Saint louis, Missouri. specializing in HOSPITALIST. They hold the professional credentials MD. They hold a License No. 2022012233 (MO). The NPI Number for DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) is 1164604138

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. ADEKUNLE OLUWATOSIN OBISESAN (MD)
NPI
1164604138
Phone
(314) 251-6486
Address
625 S NEW BALLAS RD STE 7020
Enumeration Date
3 December 2007
Last Update Date
6 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3144341500
Graduation Year
1998 (28 years ago)
PAC ID
6406972850
Group Practice PAC ID
1557366960
Professional Enrollment ID
I20240807002336
Address ID
MO630173406CH232XXRDXX500

Contacts

Secure Messaging
obisa1@mercy.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness85
Years active:18State licenses:1Other namesUpdated within 12 months

1,189 HOSPITALIST in MO

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Provider Addresses for DR. ADEKUNLE OLUWATOSIN OBISESAN (MD)

  • 625 S NEW BALLAS RD STE 7020

    SAINT LOUIS, MO 631418218

    Phone: (314) 251-6486

    Fax: (314) 251-4155

    Type: Mailing

  • Southeast Hospital, 1701, Lacey Street, Cape Girardeau, Cape Girardeau County, Missouri, 63701, United States

    CAPE GIRARDEAU, MO 637015230

    Phone: (573) 331-6431

    Fax: (573) 986-5984

    Type: Mailing

  • 625 S NEW BALLAS RD

    SAINT LOUIS, MO 631418240

    Phone: (314) 251-6486

    Fax: (314) 251-4155

    Type: Location

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 $22.

Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.

Last reported payment date: 2024-08-29 • Largest payer in this snapshot: La Jolla Pharmaceutical Company ($22).

Total Amount

$22

General + Research + Ownership

Payments

1

Total payment records

General Amount

$22

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-29

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-08-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240807002336IHospitalistMOTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63141)

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Provider's Procedures

DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) performs procedures in HOSPITALIST. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
HOSPITALISTMO36556Insertion of central venous catheter for infusion, patient 5 years or older3029

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557366960View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineMO
Internal MedicineMO
-MO
-MO
H O S P I T A L I S TMO
-MO
Internal MedicineMO
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMO
Internal MedicineMO
-MO

Reviews

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Frequently asked questions

How is DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) with NPI 1164604138.
Does the file indicate DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) is practicing under active NPI?
Directory data currently reports DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) as active.
What is DR. ADEKUNLE OLUWATOSIN OBISESAN (MD)'s primary classification?
Critical Care Medicine (Internal Medicine) Physician is the headline specialty for DR. ADEKUNLE OLUWATOSIN OBISESAN (MD) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. ADEKUNLE OLUWATOSIN OBISESAN (MD)?
DR. ADEKUNLE OLUWATOSIN OBISESAN (MD)'s geographic hint is Saint Louis, Missouri in our summary view.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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