Individual provider Active NPI

Okeowo D Ibitoye, MD

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1154322352
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0051437 Issued in MD
Practice address
2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone
(443) 481-1000
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0051437 MD Primary

Addresses

Primary practice location

2001 Medical Pkwy
Annapolis, MD 21401-3280

Mailing address

PO Box 64916
Baltimore, MD 21264-4916
Phone (443) 481-6573

Other identifiers 19

IdentifierTypeStateIssuer
60389103OtherBCBS-MD
689LD128OtherMEDICARE PIN
723540200OtherAMERIGROUP - AMERICAID
1154322352OtherNPI NUMBER
689LD128OtherWELLCARE
G71393OtherUPIN
5861765OtherAETNA / US HEALTHCARE
0481822OtherMAMSI
723540200MedicaidMD
0001OtherBCBS-DC
0039732900OtherFEDERAL BLACK LUNG BENEFITS
21699OtherJHHC
521169362OtherKAISER PERMANENTE
AH01OtherENVOY SITE ID
110178760OtherRAILROAD MEDICARE-PALMETTO
521169362OtherMULTIPLAN
2452142OtherAETNA/US HEALTHCARE HMO
D51437OtherMEDICAL LICENSE
521169362OtherAMERICHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20090317000022 DC Practitioner - Internal Medicine 7012074198 Reassigns benefits to 1 organization
I20110520000252 MD Practitioner - Internal Medicine 7012074198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12200 Annapolis Rd
Glenn Dale, MD 20769-9182
Phone (240) 245-4414

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairwood Internal Medicine Internal Medicine CurrentSince Feb 25, 2009 Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients
Maryland Cardiology Associates, LLC PastSince Feb 25, 2009 Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients

Locations

12200 Annapolis Rd
Ste 232
Glenn Dale, MD 20769
Phone (240) 245-4414

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1154322352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64916",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644916",
            "telephone_number": "443-481-6573",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013280",
            "telephone_number": "443-481-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBITOYE",
        "first_name": "OKEOWO",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0051437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MD",
            "identifier": "60389103",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "689LD128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP - AMERICAID",
            "identifier": "723540200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1154322352",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "689LD128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G71393",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA / US HEALTHCARE",
            "identifier": "5861765",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "0481822",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "723540200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-DC",
            "identifier": "0001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG BENEFITS",
            "identifier": "0039732900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC",
            "identifier": "21699",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "521169362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENVOY SITE ID",
            "identifier": "AH01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-PALMETTO",
            "identifier": "110178760",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "521169362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE HMO",
            "identifier": "2452142",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "D51437",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "521169362",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.