Organization Active NPI

Cityblock Medical Practice, P.a.

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1255108353
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CITYBLOCK MEDICAL PRACTICE, P.A.
Practice address
2301 N Meridian St
Indianapolis, IN 46208-5729
Phone
(800) 336-1100
NPI assigned
Dec 8, 2023
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Oluwatoyin T Ajayi, MDNPI 1790912426
Title
President and Sole Shareholder
Phone
(833) 904-2273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2301 N Meridian St
Indianapolis, IN 46208-5729

Mailing address

495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706
Phone (833) 904-0620

Other practice location 1

3030 Lake Ave Ste 21
Fort Wayne, IN 46805-5428
Phone (800) 336-1100

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2272543Cityblock Medical Practice, PA2301 N Meridian Street, Indianapolis, IN 46208Certificate of waiverJan 18, 2028

National Provider Directory

National Provider Directory

Locations

3030 Lake Ave
Ste 21
Fort Wayne, IN 46805
Phone (219) 482-1681

2301 N Meridian St
Indianapolis, IN 46208
Phone (317) 602-5610

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1255108353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 FLATBUSH AVE STE C5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253706",
            "telephone_number": "833-904-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085729",
            "telephone_number": "800-336-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Lake Ave Ste 21",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468055428",
            "country_code": "US",
            "telephone_number": "800-336-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CITYBLOCK MEDICAL PRACTICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "OLUWATOYIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT AND SOLE SHAREHOLDER",
        "authorized_official_telephone_number": "833-904-2273",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.