Individual provider Active NPI

Rowland O. Mbaoma, M.D.

  • Hematology & Oncology Physician
  • Munster, IN
National Provider Identifier
1174562151
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
01060241A Issued in IN
Practice address
701 Superior Ave
Franciscan Physicians Hospital
Munster, IN 46321-4037
Phone
(219) 922-4081
Fax
(219) 922-5880
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 01060241A IN Primary

Addresses

Primary practice location

701 Superior Ave
Franciscan Physicians Hospital
Munster, IN 46321-4037

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Other identifiers 2

IdentifierTypeStateIssuer
200524370MedicaidIN
463060U5OtherINMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmbaoma64247@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060241AINMDHematology & Oncology Physician

Interoperability endpoints

  • Direct secure messaging: rmbaoma64247@direct.franciscanalliance.org

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1174562151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SUPERIOR AVE",
            "address_2": "FRANCISCAN PHYSICIANS HOSPITAL",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214037",
            "telephone_number": "219-922-4081",
            "fax_number": "219-922-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAOMA",
        "first_name": "ROWLAND",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01060241A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200524370",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "463060U5",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmbaoma64247@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 Superior Ave",
            "address_2": "Franciscan Physicians Hospital",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463214037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.