Individual provider Active NPI

Babajide Runsewe, MD

  • Family Medicine Physician
  • Windsor Mill, MD
National Provider Identifier
1124220561
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0066493 Issued in MD
Practice address
3608 Milford Mill Rd
Windsor Mill, MD 21244-3328
Phone
(443) 272-7858
Fax
(443) 405-7237
NPI assigned
Jun 5, 2007
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0066493 MD Primary

Addresses

Primary practice location

3608 Milford Mill Rd
Windsor Mill, MD 21244-3328

Mailing address

3608 Milford Mill Rd
Windsor Mill, MD 21244-3328
Phone (443) 272-7858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081111000313 MD Practitioner - Family Practice 7911085436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3608 Milford Mill Rd
Windsor Mill, MD 21244-3328
Phone (443) 822-9982

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0066493MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Xtracare P.C. CurrentSince Dec 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3608 Milford Mill Rd
Windsor Mill, MD 21244
Phone (443) 272-7858

Interoperability endpoints

  • Direct secure messaging: babajide.runsewe.1@10109.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/10109/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1124220561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 MILFORD MILL RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443328",
            "telephone_number": "443-272-7858",
            "fax_number": "443-405-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 MILFORD MILL RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443328",
            "telephone_number": "443-272-7858",
            "fax_number": "443-405-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNSEWE",
        "first_name": "BABAJIDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0066493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

Verify at the official NPI Registry.