Dr Adesola Omotayo Fabayo, MD is a medicare enrolled "Anesthesiology" provider in Griffin, Georgia. His current practice location is
610 S 8th St, Suite F, Griffin, Georgia. You can reach out to his office (for appointments etc.) via phone at
(770) 228-8550.
Dr Adesola Omotayo Fabayo is licensed to practice in Georgia (license number 045782) 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 1265482285.
Healthcare Provider's Profile
Full Name | Dr Adesola Omotayo Fabayo |
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Gender | Male |
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Speciality | Anesthesiology |
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Location | 610 S 8th St, Griffin, Georgia |
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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: 1265482285
- Provider Enumeration Date: 05/11/2006
- Last Update Date: 07/16/2019
Medicare PECOS Information:
- PECOS PAC ID: 5092879049
- Enrollment ID: I20090205000544
Medical Identifiers
Medical identifiers for Dr Adesola Omotayo Fabayo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1265482285 | NPI | - | NPPES |
000870669B | Medicaid | GA | |
00870669A | Medicaid | GA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TB0200X | Psychologist - Cognitive & Behavioral | 45782 (Georgia) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | 045782 (Georgia) | Secondary |
207L00000X | Anesthesiology | 045782 (Georgia) | 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. Dr Adesola Omotayo Fabayo allows following entities to bill medicare on his behalf.
Entity Name | Oracle Anesthesia Of Georgia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1629350566 PECOS PAC ID: 5395918098 Enrollment ID: O20111025000313 |
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Entity Name | Anesthesia Consultants Of Georgia, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760752430 PECOS PAC ID: 0345400313 Enrollment ID: O20120328000888 |
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Entity Name | Sentry Anesthesia Management, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134544794 PECOS PAC ID: 9436372323 Enrollment ID: O20140521002571 |
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Entity Name | Mak Anesthesia Holdings, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
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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. Dr Adesola Omotayo Fabayo 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 |
Dr Adesola Omotayo Fabayo, MD 610 S 8th St, Suite F, Griffin, GA 30224-4201 Ph: (770) 228-8550 | Dr Adesola Omotayo Fabayo, MD 610 S 8th St, Suite F, Griffin, GA 30224-4201 Ph: (770) 228-8550 |
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