Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Samuel O Fadare Jr., MD

Individual provider Psychiatry Physician · NPI 1184685802

Dr. Samuel O Fadare Jr., MD is a Psychiatry in Gladstone, Missouri. Qualified in 1986, 40 years ago. Practices with Samuel O Fadare MD PA, a 2-clinician group and accepts Medicare assignment. Licensed in Florida, Georgia, Kansas and Michigan and 1 more.

Years since qualifying
40
Licensed in
FL, GA, KS, MI, MO
In the registry since
2006
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5604 NE Antioch Rd
Gladstone, MO 64119-2327
Phone: (660) 372-1313
Fax: (660) 372-1339
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 103939 (MO)
Psychiatry Physician Taxonomy 2084P0800X · Licence 04-24672 (KS)
Psychiatry Physician Taxonomy 2084P0800X · Licence 4301063006 (MI)
Psychiatry Physician Taxonomy 2084P0800X · Licence 90387 (GA)
Psychiatry Physician Taxonomy 2084P0800X · Licence ME157175 (FL)

Record details

NPI number1184685802
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2006
Last updated in NPPESOctober 6, 2022
Certification dateOctober 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Samuel O Fadare Md Pa — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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