Ifeoma Anagboso, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME159737 Issued in FL

Practice address

855 S Highland Ave
Clearwater, FL 33756-4446

Phone

(727) 219-1833

Fax

(727) 330-2908

NPI assigned

Apr 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, PA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (5 of 7)

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366

  FL

  Medicare reassignment NPD
• Dedicated Pennsylvania Holding, LLC

  • Specialist
  • Philadelphia, PA
  • NPI 1477053569

  PA

  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• Dedicated Pennsylvania Holding, LLC

  • Specialist
  • Philadelphia, PA
  • NPI 1366950776
  NPD
• Dedicated Pennsylvania Holding, LLC

  • Specialist
  • Philadelphia, PA
  • NPI 1841707965

  Family Medicine

  NPD

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1053940593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564446",
            "telephone_number": "727-219-1833",
            "fax_number": "727-330-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564446",
            "telephone_number": "727-219-1833",
            "fax_number": "727-330-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAGBOSO",
        "first_name": "IFEOMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME159737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2524852",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay Kumar Amin, MD
• Jigisha Sanghavi Amin, M.D.
• Mahesh Amin, MD
• Samantha Suzanne Ammann, RN, LCSW
• Amp Ltcrx LLC
• Andres Alfredo Anais, PA
• Andean Geriatric Services LLC
• Brian L. Anderson, M. D.
• Courtney Anderson, SLP
• Kathy L Anderson, D.O.

• All providers in Clearwater, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.