NPIMap

Individual provider Active NPI

Opeyemi Ajike Asanbe, M.D.

  • Plastic Surgery Physician
  • Rockford, IL
National Provider Identifier
1134419096
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
036181517 Issued in IL
Practice address
5666 E State St
Rockford, IL 61108-2425
Phone
(815) 395-9350
Fax
(815) 395-9359
NPI assigned
Apr 13, 2011
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 036181517 IL Primary

Addresses

Primary practice location

5666 E State St
Rockford, IL 61108-2425

Mailing address

5666 E State St
Rockford, IL 61108-2425
Phone (815) 395-9350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200110000028 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Internal MedicinePractitioner - General Surgery 5597092312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296583NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Plastic and Reconstructive Surgery CurrentSince Sep 1, 2023 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Temple Faculty Practice Plan, Inc Plastic Surgery CurrentSince Sep 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

333 Cottman Ave
#A
Philadelphia, PA 19111
Phone (215) 728-2581

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

6129 Palmetto St
Philadelphia, PA 19111
Phone (215) 722-8555

Interoperability endpoints

  • Direct secure messaging: oasanbe841254@nychhc.direct-ci.com

Organizations & group practices 6

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 8

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1134419096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082425",
            "telephone_number": "815-395-9350",
            "fax_number": "815-395-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082425",
            "telephone_number": "815-395-9350",
            "fax_number": "815-395-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASANBE",
        "first_name": "OPEYEMI",
        "middle_name": "AJIKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036181517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.