Individual provider Active NPI

Kristie Abimbola Akintunde, M.D

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1053793273
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00295603 Issued in NY
Practice address
1276 Fulton Ave
Bronx, NY 10456-3402
Phone
(718) 992-7669
NPI assigned
Jun 24, 2015
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63783 MN
Family Medicine Physician 207Q00000X 00295603 NY Primary

Addresses

Primary practice location

1276 Fulton Ave
Bronx, NY 10456-3402

Mailing address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2900
Phone (763) 520-2000

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-2000

Other names 1

  • Miss Kristie Abimbola Adebayo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180710000622 MN Practitioner - Hospitalist 3375899164 Reassigns benefits to 1 organization
I20181023002613 NY Practitioner - Family Practice 3375899164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
295603NYMDLicensed Practical Nurse
00295603NYMDFamily Medicine Physician
63783MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Family Medicine CurrentSince Sep 3, 2018 Accepting new patients
Bronxcare Health System CurrentSince Sep 3, 2018 Accepting new patients
North Memorial Health Care CurrentSince Feb 1, 2019 Accepting new patients
North Memorial Health Care Current Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

800 Freeport Ave NW
Ste 100
Elk River, MN 55330
Phone (763) 581-5200

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

4209 Webber Pkwy
Minneapolis, MN 55412
Phone (763) 553-0544

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1053793273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222900",
            "telephone_number": "763-520-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "55422",
            "country_code": "US",
            "telephone_number": "763-520-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKINTUNDE",
        "first_name": "KRISTIE",
        "middle_name": "ABIMBOLA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "63783",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "00295603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIE",
            "last_name": "ADEBAYO",
            "middle_name": "ABIMBOLA",
            "prefix": "MISS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.