Omodele Julie Masha

MD | Pediatrics | Female

---

Complete Profile:

Omodele Julie Masha basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics
Provider Name :	Omodele Julie Masha
Credential :	MD
Gender :	Female

Business Address:

Omodele Julie Masha address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	3601 Sw 160th Ave, Suite 250 Miramar, FL, 33027-6308 United States
Phone Number :	877-866-7123

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1528164324
NPI Entity Type :	Individual
First Enrolment Date :	16 Sep, 2006
Last Updated On :	17 Mar, 2018

Medicare Participation:

Omodele Julie Masha participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	7012951494
Medicare Enrollment ID :	I20091007000446
Primary Specialty :	Pediatric Medicine
Medical School :	University Of Minnesota Medical School
Graduation Year :	2002
Accepts Medicare?	Yes. Omodele Julie Masha accepts medicare insurance.

Group Practice Association:

Omodele Julie Masha is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Omodele Julie Masha is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Optimed Hospitalists, Pllc	8022204171	59	2001 Van Haven Dr Statesville, NC - 286254342 Ph: 7048835772	Yes
Optimed Hospitalists, Pllc	8022204171	59	557 Brookdale Dr Statesville, NC - 286774107 Ph: 7048735661	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Omodele Julie Masha are as mentioned. Primary taxonomy code for Omodele Julie Masha, MD is 208000000X (Pediatrics).

Taxonomy Code	Speciality	Primary	License No.	State
207Q00000X	Family Medicine	No	2009-01717	NC
207R00000X	Internal Medicine	No	2009-01717	NC
208000000X	Pediatrics	Yes	2009-01717	NC

Legacy Identifiers:

Other legacy medical identifiers of Omodele Julie Masha such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
NC1004	MEDICAID	SC
1051675	MEDICAID	LA
1528164324	MEDICAID	NC
09430542	MEDICAID	MS
154VV	Other	NC	BCNC

Other Practice Locations:

Practice Address	City, State	Phone Number
3601 SW 160TH AVE, SUITE 250 MIRAMAR, FL, 33027-6308 United States	MIRAMAR, FL	877-866-7123

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	200 E 2nd Ave Gastonia, NC, 28052-4358 United States
Phone Number :	704-874-0567
Fax Number :	704-874-0707

Business Location:

Patients can refer following map for directions to Omodele Julie Masha practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.