Individual provider Active NPI

Ayomide Ireti Sotomi-Foluso, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1154932291
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.076941 Issued in IL
Practice address
4646 N Marine Dr
Chicago, IL 60640-5759
Phone
(773) 564-5225
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 ME160590 FL
Internal Medicine Physician 207R00000X 125.076941 IL Primary

Addresses

Primary practice location

4646 N Marine Dr
Chicago, IL 60640-5759

Mailing address

4600 N Clarendon Ave Apt 1405
Chicago, IL 60640-5794
Phone (773) 339-7641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230901003277 FL Practitioner - Internal Medicine 9133530256 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians
Adventist Health System-Sunbelt IncGroup PAC ID 0749232445, shared by 8 NPIs, 100 clinicians

Practice addresses (Care Compare)

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 314-4466

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME160590FLMDInternal Medicine Physician
125.076941ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Aug 15, 2023 Accepting new patients
Adventist Health System-Sunbelt Inc Internal Medicine CurrentSince Aug 15, 2023 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Aug 15, 2023 Accepting new patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Aug 15, 2023 Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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.

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1154932291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 N CLARENDON AVE APT 1405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405794",
            "telephone_number": "773-339-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-564-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOMI-FOLUSO",
        "first_name": "AYOMIDE",
        "middle_name": "IRETI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160590",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.076941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.