Individual provider Active NPI

Samiat Agunbiade, M.D.

  • Surgery Physician
  • Aurora, CO
National Provider Identifier
1194259127
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR.0077635 Issued in CO
Practice address
12631 E 17TH Ave
Aurora, CO 80045-2527
Phone
(303) 724-9251
NPI assigned
Apr 17, 2017
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD483012 PA
Surgery Physician 208600000X DR.0077635 CO Primary
Vascular Surgery Physician 2086S0129X DR.0077635 CO

Addresses

Primary practice location

12631 E 17TH Ave
Aurora, CO 80045-2527

Mailing address

12631 E 17TH Ave
Aurora, CO 80045-2527
Phone (303) 724-9251

Other practice location 1

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (484) 227-9400

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT222104PAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1194259127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527",
            "telephone_number": "303-724-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527",
            "telephone_number": "303-724-9251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 W Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635104",
            "country_code": "US",
            "telephone_number": "484-227-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUNBIADE",
        "first_name": "SAMIAT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD483012",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0077635",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CO",
            "license": "DR.0077635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.