DR. OLUGBENGA O OBASANJO (MBBS MPH PHD FACPM) – Public Health & General Preventive Medicine Physician, NPI 1225328099
Public Health & General Preventive Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
32 PREVENTIVE MEDICINE in VA
Provider Addresses for DR. OLUGBENGA O OBASANJO (MBBS MPH PHD FACPM)
1320 CENTRAL PARK BLVD STE 300
FREDERICKSBURG, VA 224014954
Phone: (540) 322-5930
Type: Location
7818 CEDAR BRANCH DR
GAINESVILLE, VA 201551990
Phone: (571) 248-0763
Type: Mailing
9301 LEE AVE
MANASSAS, VA 201105517
Phone: (703) 792-7333
Fax: (703) 792-6338
Type: Location
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: 2021-07-22
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 |
|---|---|---|---|---|
| I20210722003145 | I | Preventive Medicine | VA | 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 |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 16 | 16 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 16 | 16 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 11 | 11 | $0 |
| G0008 | Administration of influenza virus vaccine | 11 | 11 | $0 |
Insurance plans in this area (ZIP 22401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VA | |
| - | VA | |
| - | VA | |
| Nurse Practitioner | VA |
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