Oladiji Gbolahan Vaughan, MD is a medicare enrolled "Pediatrics" physician in San Tan Valley, Arizona. His current practice location is
36351 N Gantzel Rd Ste 127, San Tan Valley, Arizona. You can reach out to his office (for appointments etc.) via phone at
(480) 336-2815.
Oladiji Gbolahan Vaughan is licensed to practice in Arizona (license number 40162) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043498520.
Physician's Profile
Full Name | Oladiji Gbolahan Vaughan |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 36351 N Gantzel Rd Ste 127, San Tan Valley, Arizona |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043498520
- Provider Enumeration Date: 02/06/2008
- Last Update Date: 01/31/2024
Medicare PECOS Information:
- PECOS PAC ID: 9335215391
- Enrollment ID: I20080828000106
Medical Identifiers
Medical identifiers for Oladiji Gbolahan Vaughan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043498520 | NPI | - | NPPES |
358032-01 | Medicaid | AZ | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208M00000X | Hospitalist | 40162 (Arizona) | Secondary |
208000000X | Pediatrics | 40162 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Oladiji Gbolahan Vaughan allows following entities to bill medicare on his behalf.
Entity Name | Springfield Medical Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093019150 PECOS PAC ID: 0345422879 Enrollment ID: O20110304000496 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Oladiji Gbolahan Vaughan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Oladiji Gbolahan Vaughan, MD 36351 N Gantzel Rd Ste 127, San Tan Valley, AZ 85140-7033 Ph: (480) 336-2815 | Oladiji Gbolahan Vaughan, MD 36351 N Gantzel Rd Ste 127, San Tan Valley, AZ 85140-7033 Ph: (480) 336-2815 |
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