Dr Olatunji Jonathan Oluwatade, MD - Medicare Infectious Disease in Vicksburg, MS

Dr Olatunji Jonathan Oluwatade, MD is a medicare enrolled "Internal Medicine - Infectious Disease" physician in Vicksburg, Mississippi. He graduated from medical school in 1987 and has 37 years of diverse experience with area of expertise as Infectious Disease. He is a member of the group practice Medical Associates Of Vicksburg Pllc, Kcc Infusion, Llc and his current practice location is 2080 S, Frontage Rd., Suite100, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 262-1000.

Dr Olatunji Jonathan Oluwatade is licensed to practice in Mississippi (license number 19904) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477677458.

Contact Information

Dr Olatunji Jonathan Oluwatade, MD
2080 S, Frontage Rd., Suite100,
Vicksburg, MS 39180-5883
(601) 262-1000
Not Available



Physician's Profile

Full NameDr Olatunji Jonathan Oluwatade
GenderMale
SpecialityInfectious Disease
Experience37 Years
Location2080 S, Frontage Rd., Vicksburg, Mississippi
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Olatunji Jonathan Oluwatade graduated from medical school in 1987
  NPI Data:
  • NPI Number: 1477677458
  • Provider Enumeration Date: 03/16/2007
  • Last Update Date: 03/13/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8628158326
  • Enrollment ID: I20080115000320

Medical Identifiers

Medical identifiers for Dr Olatunji Jonathan Oluwatade such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477677458NPI-NPPES
1811254MedicaidLA
08108016MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 4301089363 (Michigan)Secondary
207P00000XEmergency Medicine 19904 (Mississippi)Secondary
208M00000XHospitalist 19904 (Mississippi)Secondary
207RI0200XInternal Medicine - Infectious Disease 19904 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kindred At Home -flowoodFlowood, MSHome health agency
Sta Home Health And HospiceClinton, MSHome health agency
Merit Health River RegionVicksburg, MSHospital
Merit Health River OaksFlowood, MSHospital
Mississippi Baptist Medical CenterJackson, MSHospital
Merit Health MadisonCanton, MSHospital
Crossgates River Oaks HospitalBrandon, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Medical Associates Of Vicksburg Pllc35777823669
Kcc Infusion, Llc46880768962

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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 Olatunji Jonathan Oluwatade allows following entities to bill medicare on his behalf.
Entity NameVicksburg Healthcare Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629084058
PECOS PAC ID: 4688575129
Enrollment ID: O20040213000299

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Entity NameRiver Oaks Management Company Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922029040
PECOS PAC ID: 0345233110
Enrollment ID: O20040407000093

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Entity NameBaptist Medical Center - Yazoo, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619918075
PECOS PAC ID: 5799850376
Enrollment ID: O20080815000433

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Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215987441
PECOS PAC ID: 8628980992
Enrollment ID: O20131122000662

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Entity NameMedical Associates Of Vicksburg Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508278177
PECOS PAC ID: 3577782366
Enrollment ID: O20140909002017

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Entity NameWound Care Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568793750
PECOS PAC ID: 0840314548
Enrollment ID: O20160920000827

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Entity NameKcc Infusion, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942875158
PECOS PAC ID: 4688076896
Enrollment ID: O20210712000313

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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 Olatunji Jonathan Oluwatade 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 AddressPractice Location Address
Dr Olatunji Jonathan Oluwatade, MD
2080 S Frontage Rd, Suite 100,
Vicksburg, MS 39180-5328

Ph: (601) 262-1000
Dr Olatunji Jonathan Oluwatade, MD
2080 S, Frontage Rd., Suite100,
Vicksburg, MS 39180-5883

Ph: (601) 262-1000

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Read more News

› Verified 5 days ago


Internal Medicine Doctors in Vicksburg, MS

Michael L Davis, MD
Infectious Disease
Medicare: Medicare Enrolled
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-630-9755    
Murray P Whitaker, MD
Infectious Disease
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-5000    
Dr. Charles A. Marascalco, MD
Infectious Disease
Medicare: Not Enrolled in Medicare
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-4373    Fax: 601-883-4309
Dr. Raman Jeet Sohal,
Infectious Disease
Medicare: Medicare Enrolled
Practice Location: 1202 Mission Park Dr, Vicksburg, MS 39180
Phone: 601-738-5549    
Dr. Karan Puri, MD
Infectious Disease
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-5000    
Albert F Chiemprabha, MD
Infectious Disease
Medicare: Accepting Medicare Assignments
Practice Location: 1815 Mission 66, Vicksburg, MS 39180
Phone: 601-355-1234    Fax: 601-326-3559
Dr. Karthik Yeruva, MD
Infectious Disease
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183
Phone: 601-883-5946    

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